M C LACAYO MD PA
Osteopathic Medicine at 23 Ter, Boca Raton, FL

License number
Florida ME47330
Category
Osteopathic Medicine
Type
Geriatric Medicine
Owner
Name: MARTHA CECILIA LACAYO MD
Title: PRESIDENT
Phone: (561) 338-8320
Address
Address
6623 NW 23Rd Ter, Boca Raton, FL 33496
National Provider ID: 1134300031
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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DR. M. C. LACAYO, M.D., PA

Boca Raton, FL

Industry:
Medical Doctor's Office
Registration:
Apr 29, 1991
Addresses:
6623 NW 23 Ter, Boca Raton, FL 33496 (Physical)
2300 Glades Rd, Boca Raton, FL 33431
State ID:
S49660
Business type:
Florida Profit Corporation
President, Directors:
M. Cecilia Lacayo, 6623 NW 23 Ter, Boca Raton, FL 33496 (Physical),Lacayo M. Cecilia (President, Director)
Agent:
Leo, Thomas,6623 NW 23 Ter, Boca Raton, FL 33496 (Physical)
EIN:
65-0258056

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