Provider Demographics
NPI:1679929921
Name:LALL, ALEX PARAM (MD)
Entity Type:Individual
Prefix:MR
First Name:ALEX
Middle Name:PARAM
Last Name:LALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1611 NW 12TH AVENUE
Mailing Address - Street 2:DEPARTMENT OF SURGERY HOLTZ EAST TOWER 2169
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125
Mailing Address - Country:US
Mailing Address - Phone:305-585-1280
Mailing Address - Fax:305-585-6043
Practice Address - Street 1:1611 NW 12TH AVENUE
Practice Address - Street 2:DEPARTMENT OF SURGERY HOLTZ EAST TOWER 2169
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125
Practice Address - Country:US
Practice Address - Phone:305-585-1280
Practice Address - Fax:305-585-6043
Is Sole Proprietor?:No
Enumeration Date:2016-05-05
Last Update Date:2017-04-20
Deactivation Date:2017-01-03
Deactivation Code:
Reactivation Date:2017-04-20
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program