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General NPI Number Information
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NPI Number | 1336932334
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Entity Type | Organization
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Legal Business Name | PROMOTORA MEDICA Y ODONTOLOGICA DE ANTIOQUIA S.A.
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Dates
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Enumeration Date | 05/23/2025
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Last Update Date | 05/23/2025
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Provider Practice Location Address
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Address Line | CALLE 53 46 38 PISO 1, LA CANDELARIA
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City | MEDELLIN
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State | ANTIOQUIA
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Zip | 99999
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Country | CO
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Telephone | 604-322-1125
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 11597
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City | FORT LAUDERDALE
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State | FL
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Zip | 33339-1597
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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 | MGR
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Name | WILFER SANTIAGO
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Credential |
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Telephone | 604-322-1125
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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