Healthcare Provider Details

I. General information

NPI: 1356987812
Provider Name (Legal Business Name): HOSPITAL BALBOA S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2019
Last Update Date: 11/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AV CAMARON SABALO 4480 ZONA DORADA
MAZATLAN SINALOA
82110
MX

IV. Provider business mailing address

PO BOX 39662
FORT LAUDERDALE FL
33339-9662
US

V. Phone/Fax

Practice location:
  • Phone: 526-699-1679
  • 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: DR. ENRIQUE CRUZ
Title or Position: MANAGER
Credential:
Phone: 954-526-9751