NPIMap

Organization Active NPI

Lago Mental Health Corp

Doing business as Lago Medical Center

  • Primary Care Clinic/Center
  • Cutler Bay, FL
National Provider Identifier
1356000640
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
LAGO MENTAL HEALTH CORP
Doing business as
Lago Medical Center
Practice address
11055 SW 186TH St Ste 207
Cutler Bay, FL 33157-6842
Phone
(786) 692-5743
Fax
(786) 422-9043
NPI assigned
Dec 14, 2021
Last updated
Mar 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Adlay Lago JrNPI 1790300473
Title
Authorized Official
Phone
(786) 483-5523

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU Primary

Addresses

Primary practice location

11055 SW 186TH St Ste 207
Cutler Bay, FL 33157-6842

Mailing address

11055 SW 186TH St Ste 207
Cutler Bay, FL 33157-6842
Phone (786) 692-5743

Other identifiers 1

IdentifierTypeStateIssuer
112907000MedicaidFL

Other names 1

  • Lago Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220126000930 FL Part B Supplier - Clinic/Group Practice 3577955491 Receives reassigned benefits from 5 practitioners
Practice locations: Cutler Bay, FL

National Provider Directory

National Provider Directory
Tax ID family
Lago Medical Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

11055 SW 186th St
Ste 2017
Cutler Bay, FL 33157

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1639440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741651200000",
    "number": "1356000640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11055 SW 186TH ST STE 207",
            "city": "CUTLER BAY",
            "state": "FL",
            "postal_code": "331576842",
            "telephone_number": "786-692-5743",
            "fax_number": "786-422-9043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11055 SW 186TH ST STE 207",
            "city": "CUTLER BAY",
            "state": "FL",
            "postal_code": "331576842",
            "telephone_number": "786-692-5743",
            "fax_number": "786-422-9043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAGO MENTAL HEALTH CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-14",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A",
        "authorized_official_last_name": "LAGO JR",
        "authorized_official_first_name": "ADLAY",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "786-483-5523"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112907000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lago Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lago Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cutler Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.