Provider Demographics
NPI:1831129907
Name:LERMO, MARGARITA (MD)
Entity Type:Individual
Prefix:
First Name:MARGARITA
Middle Name:
Last Name:LERMO
Suffix:
Gender:F
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:PO BOX 558926
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33255-8926
Mailing Address - Country:US
Mailing Address - Phone:305-466-1900
Mailing Address - Fax:305-262-6426
Practice Address - Street 1:7821 CORAL WAY
Practice Address - Street 2:SUITE 121
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-6542
Practice Address - Country:US
Practice Address - Phone:305-446-1900
Practice Address - Fax:305-262-6426
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME333142084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL984631OtherUSA MGD CARE ORG NUMBER
FL95518OtherBLUE CROSS BLUE SHIELD FL
FL039636201Medicaid
FL95518OtherBLUE CROSS BLUE SHIELD FL
FLD63495Medicare UPIN