Provider Demographics
NPI:1679742019
Name:PREFERRED MEDICAL CENTER LLC
Entity Type:Organization
Organization Name:PREFERRED MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURO
Authorized Official - Middle Name:G
Authorized Official - Last Name:LAPUZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-547-2164
Mailing Address - Street 1:60 SON IN LAW RD
Mailing Address - Street 2:
Mailing Address - City:BONIFAY
Mailing Address - State:FL
Mailing Address - Zip Code:32425-3201
Mailing Address - Country:US
Mailing Address - Phone:850-547-2164
Mailing Address - Fax:
Practice Address - Street 1:60 SON IN LAW RD
Practice Address - Street 2:
Practice Address - City:BONIFAY
Practice Address - State:FL
Practice Address - Zip Code:32425-3201
Practice Address - Country:US
Practice Address - Phone:850-547-2164
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service