Provider Demographics
NPI:1366478059
Name:MARGARITA LERMO MD PA
Entity Type:Organization
Organization Name:MARGARITA LERMO MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARGARITA
Authorized Official - Middle Name:
Authorized Official - Last Name:LERMO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-446-1900
Mailing Address - Street 1:PO BOX 558926
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33255-8926
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:305-262-6426
Practice Address - Street 1:7821 CORAL WAY
Practice Address - Street 2:SUITE 121
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-6542
Practice Address - Country:US
Practice Address - Phone:305-446-1900
Practice Address - Fax:305-446-1080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME333142084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
984631OtherUSA MANAGED CARE
FL95518OtherBLUE CROSS BLUE SHIELD OF
FL039636201Medicaid
FLBS826AMedicare PIN