Provider Demographics
NPI:1073903928
Name:LEAD MEDICAL CENTER INC
Entity Type:Organization
Organization Name:LEAD MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROLANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ FIGUEREDO
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:786-420-5742
Mailing Address - Street 1:4355 W 16TH AVE STE 206B
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-7643
Mailing Address - Country:US
Mailing Address - Phone:786-420-5742
Mailing Address - Fax:786-420-5928
Practice Address - Street 1:4355 W 16TH AVE STE 206B
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-7643
Practice Address - Country:US
Practice Address - Phone:786-420-5742
Practice Address - Fax:786-420-5928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-30
Last Update Date:2015-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME118298261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service