Healthcare Provider Details

I. General information

NPI: 1053840561
Provider Name (Legal Business Name): CENTRO MEDICO DE COZUMEL SA DE CV
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2017
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE 1RA SUR NO. 101 ADOLFO LOPEZ MATEO
COZUMEL QUINTANA ROO
77640
MX

IV. Provider business mailing address

PO BOX 11198
FORT LAUDERDALE FL
33339-1198
US

V. Phone/Fax

Practice location:
  • Phone: 987-872-9400
  • Fax:
Mailing address:
  • Phone: 954-526-9751
  • 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: VERONICA CASTRO
Title or Position: CP
Credential:
Phone: 954-526-9751