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General NPI Number Information
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NPI Number | 1023496403
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Entity Type | Organization
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Legal Business Name | CENTRO MEDICO HISPANO CORP
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Dates
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Enumeration Date | 05/18/2015
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Last Update Date | 05/18/2015
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Provider Practice Location Address
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Address Line | 9300 NW 25TH ST 209
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City | DORAL
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State | FL
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Zip | 33172-1508
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Country | US
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Telephone | 305-647-7383
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Fax | 786-534-3568
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Provider Business Mailing Address
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Address Line | 9300 NW 25TH ST 209
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City | DORAL
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State | FL
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Zip | 33172-1508
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Country | US
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Telephone | 305-647-7383
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Fax | 786-534-3568
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. ROSALVA ZEGARRA
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Credential | PA
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Telephone | 305-647-7383
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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