Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | ME067980 | FL |
N | 2080P0201X | Pediatric Allergist | ME067980 | FL |
NPI | 1710034129 |
---|---|
Provider Name | Dr. Miguel J Lanz |
First Address | Coral Gables, FL 33134-4301 |
Second Address | Coral Gables, FL 33134-4301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2007 |
Last Update Date | 15/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
252786300 | (05) | FL |
G45316 | (02) | FL |