Provider Demographics
NPI:1124843669
Name:LAMIS MEDICAL LLC
Entity type:Organization
Organization Name:LAMIS MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MALIK
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMDAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-641-7477
Mailing Address - Street 1:14832 NORMANS CAY CIR APT 102
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33559-3502
Mailing Address - Country:US
Mailing Address - Phone:813-955-3078
Mailing Address - Fax:
Practice Address - Street 1:14832 NORMANS CAY CIR APT 102
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33559-3502
Practice Address - Country:US
Practice Address - Phone:813-955-3078
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PEDEXPRESS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty