Provider Demographics
NPI:1285177501
Name:LAS AMERICAS MEDICAL CENTER LLC
Entity type:Organization
Organization Name:LAS AMERICAS MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTA
Authorized Official - Middle Name:ROSA
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-608-0524
Mailing Address - Street 1:11865 SW 26TH ST STE G10
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-2471
Mailing Address - Country:US
Mailing Address - Phone:786-452-0663
Mailing Address - Fax:786-452-0660
Practice Address - Street 1:11865 SW 26TH ST STE G10
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-2471
Practice Address - Country:US
Practice Address - Phone:786-452-0663
Practice Address - Fax:786-452-0660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-18
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty