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General NPI Number Information
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NPI Number | 1598427130
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Entity Type | Organization
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Legal Business Name | CENTRO DE SALUD FAMILIAR NORCROSS MEDICAL CLINIC LLC
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Dates
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Enumeration Date | 10/11/2021
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Last Update Date | 01/03/2025
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Provider Practice Location Address
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Address Line | 5836 BUFORD HWY STE C
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City | NORCROSS
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State | GA
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Zip | 30071-2581
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Country | US
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Telephone | 770-734-9920
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Fax | 770-734-9115
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Provider Business Mailing Address
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Address Line | 5717 ALLEE WAY
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City | BRASELTON
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State | GA
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Zip | 30517-6200
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Country | US
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Telephone | 678-333-3498
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Fax |
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Authorized Official
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Title or Position | OWNER, CFO
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Name | MR. RODRIGO PARRA
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Credential |
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Telephone | 678-333-3498
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP0904X
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Taxonomy Name | Federal Public Health Clinic/Center
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License Number |
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License Number State |
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