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NPI Code Detail

MEDICARE: GIANA MEDICAL CENTER CLINICA HISPANA CORP

MEDICARE: GIANA MEDICAL CENTER CLINICA HISPANA CORP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208D00000XGeneral Practice Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194340018
Entity Type Code : Organization
Provider Name (Legal Business Name) : GIANA MEDICAL CENTER CLINICA HISPANA CORP
Provider Business Mailing Address
First Line : 13240 N CLEVELAND AVE STE 2&3
Second Line :
City : NORTH FORT MYERS
State : FL
Zip : 33903-4855
Country : US
Telephone Number : 239-599-4986
Fax Number : 239-205-6101
Provider Business Practice Location Address
First Line : 13240 N CLEVELAND AVE STE 2-3
Second Line :
City : NORTH FORT MYERS
State : FL
Zip : 33903-4855
Country : US
Telephone Number : 239-599-4986
Fax Number : 239-205-6101
Authorized Official
Title or Position : PRESIDENT
Name : MRS. ANA IVIS CABRERA GONZALEZ
Credential : APRN
Telephone Number : 239-599-4986
Provider Enumeration Date : 06/16/2020
Last Update Date : 09/19/2024

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Directions to “GIANA MEDICAL CENTER CLINICA HISPANA CORP ” Practice Location

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