MEDICARE: LAS AMERICAS MEDICAL CENTER LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician		FL

General Provider Information

NPI Number	:	1285177501
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAS AMERICAS MEDICAL CENTER LLC

Provider Business Mailing Address
First Line	:	11865 SW 26TH ST STE G10
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-2471
Country	:	US
Telephone Number	:	786-452-0663
Fax Number	:	786-452-0660

Provider Business Practice Location Address
First Line	:	11865 SW 26TH ST STE G10
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-2471
Country	:	US
Telephone Number	:	786-452-0663
Fax Number	:	786-452-0660

Authorized Official
Title or Position	:	MGR/CEO
Name	:	DR. MARTA ROSA FERNANDEZ
Credential	:	MD
Telephone Number	:	305-608-0524

Provider Enumeration Date	:	11/18/2016
Last Update Date	:	02/02/2017

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Directions to “LAS AMERICAS MEDICAL CENTER LLC ” Practice Location

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