Provider Demographics
NPI:1396779088
Name:LAMAS, GERVASIO A (MD)
Entity type:Individual
Prefix:
First Name:GERVASIO
Middle Name:A
Last Name:LAMAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 402808
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-0808
Mailing Address - Country:US
Mailing Address - Phone:305-695-0644
Mailing Address - Fax:305-695-0662
Practice Address - Street 1:4308 ALTON RD
Practice Address - Street 2:#910
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2840
Practice Address - Country:US
Practice Address - Phone:305-695-0644
Practice Address - Fax:305-695-0662
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME69106207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL375004300Medicaid
FL375004300Medicaid
FLA56837Medicare UPIN