Provider Demographics
NPI:1740463124
Name:LA KAY MEDICAL CORP
Entity type:Organization
Organization Name:LA KAY MEDICAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ARMANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAZAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-722-2232
Mailing Address - Street 1:1726 NW 36TH ST
Mailing Address - Street 2:SUITE 23
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33142-5433
Mailing Address - Country:US
Mailing Address - Phone:305-722-2232
Mailing Address - Fax:786-220-9734
Practice Address - Street 1:1726 NW 36TH ST
Practice Address - Street 2:SUITE 23
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142-5433
Practice Address - Country:US
Practice Address - Phone:305-722-2232
Practice Address - Fax:786-220-9734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-09
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC 7918261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHCC7918OtherAHCA LICENSE