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General NPI Number Information
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NPI Number | 1134948722
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Entity Type | Organization
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Legal Business Name | P G OF M S.A. DE C.V.
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Dates
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Enumeration Date | 10/09/2024
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | LA BEGONA MZ 23 LT 11 COL MONTERREAL RSDAL
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City | SAN JOSE DEL CABO
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State | BAJA CALIFORNIA SUR
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Zip | 23444
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Country | MX
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Telephone | 624-211-8570
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 11661
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City | FORT LAUDERDALE
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State | FL
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Zip | 33339-1661
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | JOSE ZEFERINO
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Credential |
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Telephone | 954-526-9751
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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