Healthcare Provider Details

I. General information

NPI: 1104630060
Provider Name (Legal Business Name): HOSPITAL MEDICA CANCUN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2025
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVENIDA NICHUPTE
CANCUN QUINTANA ROO
77533
MX

IV. Provider business mailing address

PO BOX 11597
FORT LAUDERDALE FL
33339-1597
US

V. Phone/Fax

Practice location:
  • Phone: 998-364-4662
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: FABIAN CRISTOBAL
Title or Position: MANAGER
Credential:
Phone: 998-364-4661