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General NPI Number Information
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NPI Number | 1174203673
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Entity Type | Organization
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Legal Business Name | GUATEMALAN-MAYA CENTER
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Dates
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Enumeration Date | 07/19/2023
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Last Update Date | 07/19/2023
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Provider Practice Location Address
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Address Line | 1776 LAKE WORTH RD
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City | LAKE WORTH
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State | FL
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Zip | 33460-3692
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Country | US
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Telephone | 561-547-0085
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Fax |
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Provider Business Mailing Address
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Address Line | 1776 LAKE WORTH RD
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City | LAKE WORTH
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State | FL
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Zip | 33460-3692
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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 | CLINIC DIRECTOR
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Name | DANNA TORRES
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Credential |
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Telephone | 561-547-0085
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1000X
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Taxonomy Name | Migrant Health Clinic/Center
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License Number |
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License Number State |
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