Provider Demographics
NPI:1427004035
Name:F&L MEDICAL GROUP, CORP.
Entity Type:Organization
Organization Name:F&L MEDICAL GROUP, CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LAZARO
Authorized Official - Middle Name:W
Authorized Official - Last Name:GOMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-506-0283
Mailing Address - Street 1:285 NW 27TH AVE
Mailing Address - Street 2:SUITE # 14
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-5131
Mailing Address - Country:US
Mailing Address - Phone:786-507-2806
Mailing Address - Fax:786-507-2807
Practice Address - Street 1:285 NW 27TH AVE
Practice Address - Street 2:SUITE # 14
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-5131
Practice Address - Country:US
Practice Address - Phone:786-507-2806
Practice Address - Fax:786-507-2807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty