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General NPI Number Information
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NPI Number | 1326742370
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Entity Type | Organization
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Legal Business Name | CLINICA SANTA MARIA
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Dates
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Enumeration Date | 03/27/2023
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Last Update Date | 03/27/2023
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Provider Practice Location Address
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Address Line | CLINICA SANTA MARIA AVE NINOS HEROES NO 37 ESQ SIMON MORUA Y AGUILLES SORDA
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City | PUERTO PENASCO
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State | SONORA
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Zip | 83550
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Country | MX
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Telephone | 888-449-7799
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Fax |
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Provider Business Mailing Address
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Address Line | 500 WESTOVER DR # 19593
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City | SANFORD
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State | NC
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Zip | 27330-8941
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Country | US
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Telephone | 888-449-7799
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Fax |
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Authorized Official
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Title or Position | MGR
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Name | JAVIER EZQUERRA
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Credential | MD
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Telephone | 888-449-7799
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number |
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License Number State |
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