Healthcare Provider Details

I. General information

NPI: 1053453415
Provider Name (Legal Business Name): CYL MEDICAL CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 09/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1440 79TH STREET CSWY SUITE 102
NORTH BAY VILLAGE FL
33141-4188
US

IV. Provider business mailing address

1440 79TH STREET CSWY SUITE 102
NORTH BAY VILLAGE FL
33141-4188
US

V. Phone/Fax

Practice location:
  • Phone: 305-866-5880
  • Fax: 305-866-9441
Mailing address:
  • Phone: 305-866-5880
  • Fax: 305-866-9441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: CONSUELO CORRECHET
Title or Position: PRESIDENT
Credential:
Phone: 305-866-5880