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Contact Information

MIRTA M MEDEROS LEZCANO, MD
7700 W SUNRISE BLVD # 200
PLANTATION, FL33322-4113
 Phone: 954-838-2371
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
Indicates primary specialty

NPI Profile & details for MIRTA M MEDEROS LEZCANO · (Female)

NPI Number 1164495289
Status Active
Credentials MD
Entity Individual
Enumeration date 02/09/2006
Last updated 03/26/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • FL License # ME64316
  • FL Medicaid 262363300
Hospital affiliation(s)
  • MEMORIAL HOSPITAL WEST - (Acute Care)
    703 N FLAMINGO RD
    PEMBROKE PINES, FL 33028
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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