Basic Information
| Provider Information | |||||||||
| NPI: | 1043621238 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LAM HERNANDEZ | ||||||||
| FirstName: | MEYLIN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1395 NW 167TH ST | ||||||||
| Address2: | |||||||||
| City: | MIAMI GARDENS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331695710 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 5961 NW 173RD DR | ||||||||
| Address2: | |||||||||
| City: | HIALEAH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330155114 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055567500 | ||||||||
| FaxNumber: | 3056986521 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/11/2014 | ||||||||
| LastUpdateDate: | 12/16/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 12/16/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QS1201X | 132303 | FL | N | Allopathic & Osteopathic Physicians | Family Medicine | Sleep Medicine | 207Q00000X | ME132303 | FL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.