Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Blue Lagoon Medical Center Inc

Organization Family Medicine Physician · NPI 1083097281

Blue Lagoon Medical Center Inc is a Family Medicine Physician in Hialeah, Florida. Registered with an NPI since 2015.

In the registry since
2015
Specialties on file
3
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4355 W 16th Ave Ste 211A
Hialeah, FL 33012-7670
Phone: (786) 304-9107
Fax: (786) 364-0230
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
General Practice Physician Taxonomy 208D00000X
Clinic/Center Taxonomy 261Q00000X

Record details

NPI number1083097281
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ricardo Montpeller Acosta — President · (786) 304-9107
NPI enumeratedJuly 7, 2015
Last updated in NPPESJuly 8, 2015
Mailing address4355 W 16th Ave Ste 211a, Hialeah, FL 33012-7670

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