Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NX0800X | Chiropractor Orthopedic Specialist | CH0003053 | FL |
NPI | 1235188616 |
---|---|
Provider Name | Dr. Miguel Angel Lalama |
First Address | Coral Gables, FL 33134-1644 |
Second Address | Coral Gables, FL 33134-1644 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
208 | LICENSE (01) | ID |
U52159 | (02) | FL |