Provider Demographics
NPI:1003012741
Name:OSCAR LORET DE MOLA MD PA
Entity Type:Organization
Organization Name:OSCAR LORET DE MOLA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:
Authorized Official - Last Name:LORET DE MOLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-274-8243
Mailing Address - Street 1:6800 BIRD RD
Mailing Address - Street 2:SUITE 503
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-3708
Mailing Address - Country:US
Mailing Address - Phone:305-274-8243
Mailing Address - Fax:305-274-8482
Practice Address - Street 1:7775 SW 87TH AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-2536
Practice Address - Country:US
Practice Address - Phone:305-274-8243
Practice Address - Fax:305-274-8482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric GastroenterologyGroup - Single Specialty