Provider Demographics
NPI:1992773246
Name:LALAMA, HECTOR A (MD PA)
Entity type:Individual
Prefix:
First Name:HECTOR
Middle Name:A
Last Name:LALAMA
Suffix:
Gender:M
Credentials:MD PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 SANTIAGO ST
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2518
Mailing Address - Country:US
Mailing Address - Phone:305-448-9797
Mailing Address - Fax:305-448-9791
Practice Address - Street 1:801 SANTIAGO ST
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2518
Practice Address - Country:US
Practice Address - Phone:305-448-9797
Practice Address - Fax:305-448-9791
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-11
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0582302084N0400X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL058085600Medicaid
FL058085600Medicaid
FLF19432Medicare UPIN