MEDICARE: BLUE LAGOON MEDICAL CENTER INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	208D00000X	General Practice Physician
2	261Q00000X	Clinic/Center
3	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1083097281
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLUE LAGOON MEDICAL CENTER INC

Provider Business Mailing Address
First Line	:	4355 W 16TH AVE STE 211A
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-7670
Country	:	US
Telephone Number	:	786-304-9107
Fax Number	:	786-364-0230

Provider Business Practice Location Address
First Line	:	4355 W 16TH AVE STE 211A
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-7670
Country	:	US
Telephone Number	:	786-304-9107
Fax Number	:	786-364-0230

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RICARDO MONTPELLER ACOSTA
Credential	:	MA
Telephone Number	:	786-304-9107

Provider Enumeration Date	:	07/07/2015
Last Update Date	:	07/08/2015

Similar Medicare Providers

1831432160 — ELITE REHAB&MEDICAL CENTER CORP.
Practice Location Address:

4355 W 16TH AVE STE 212
HIALEAH, FL
33012-7670

Practice Phone: 305-979-6178
Practice Fax:

1588085542 — VISTA MEDICAL REHEB CENTER. INC
Practice Location Address:

4355 W 16 AVE SUITE 212
HIALEAH, FL
33012-7670

Practice Phone: 786-487-1786
Practice Fax:

1316337660 — LAS ROSAS REHAB CENTER INC
Practice Location Address:

4355 W 16TH AVE STE 212
HIALEAH, FL
33012-7670

Practice Phone: 786-499-9950
Practice Fax: 786-401-8150

1790517688 — GABRIELA MARY PEREZ CRUZ
Practice Location Address:

6215 W 22ND CT APT 19
HIALEAH, FL
33016-3985

Practice Phone: 786-797-7670
Practice Fax:

1700379047 — DR. LAUREN WILSON LOVE MD
Practice Location Address:

1650 COCHRANE CIR
FORT CARSON, CO
80913-4613

Practice Phone: 719-526-7670
Practice Fax:

1881742021 — DR. LUIS ALBERTO LOPEZ CASTRO M.D.
Practice Location Address:

3047 AVE EMILIO FAGOT
PONCE, PR
00716-4115

Practice Phone: 787-841-7194
Practice Fax: 787-841-7194

Directions to “BLUE LAGOON MEDICAL CENTER INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.