MEDICARE: ALBERTO LUIS LAGO BS

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	104100000X	Social Worker
2	171M00000X	Case Manager/Care Coordinator

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407097603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALBERTO LUIS LAGO BS

Provider Business Mailing Address
First Line	:	11031 NE 6TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33161-7182
Country	:	US
Telephone Number	:	305-398-6100
Fax Number	:	305-757-4465

Provider Business Practice Location Address
First Line	:	14400 NW 77TH CT STE 100
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33016-1590
Country	:	US
Telephone Number	:	786-916-6073
Fax Number	:	786-657-3092

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2009
Last Update Date	:	08/18/2022

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Directions to “ ALBERTO LUIS LAGO BS” Practice Location

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