Provider Demographics
NPI:1497407019
Name:LAGO CARE INC
Entity Type:Organization
Organization Name:LAGO CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ADLAY
Authorized Official - Middle Name:
Authorized Official - Last Name:LAGO
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:786-483-5523
Mailing Address - Street 1:15108 SW 141ST TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-4692
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15108 SW 141ST TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-4692
Practice Address - Country:US
Practice Address - Phone:786-483-5523
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-25
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care