Provider Demographics
NPI:1376852871
Name:MIAMI LAKES MEDICAL SOLUTIONS, INC
Entity Type:Organization
Organization Name:MIAMI LAKES MEDICAL SOLUTIONS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:TOUHEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-274-3004
Mailing Address - Street 1:8061 NW 155TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5874
Mailing Address - Country:US
Mailing Address - Phone:239-274-3004
Mailing Address - Fax:239-274-6007
Practice Address - Street 1:3822 BROADWAY
Practice Address - Street 2:SUITES A AND C
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-8148
Practice Address - Country:US
Practice Address - Phone:239-274-3004
Practice Address - Fax:239-274-6007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-30
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty