Provider Demographics
NPI:1114963253
Name:L C MEDICAL CENTER
Entity Type:Organization
Organization Name:L C MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ISMAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LABRADOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-244-2546
Mailing Address - Street 1:13985 SW 20TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-7002
Mailing Address - Country:US
Mailing Address - Phone:305-244-2546
Mailing Address - Fax:
Practice Address - Street 1:7000 W 12TH AVE
Practice Address - Street 2:SUITE 20
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-5154
Practice Address - Country:US
Practice Address - Phone:305-362-6868
Practice Address - Fax:305-362-6870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty