=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750108866
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | INMMED S.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/21/2024
-----------------------------------------------------
Last Update Date | 09/21/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 153, LIBRAMIENTO CARRETERA, LIB. A CHAPALA
-----------------------------------------------------
City | AJIJIC
-----------------------------------------------------
State | JALISCO
-----------------------------------------------------
Zip | 45922
-----------------------------------------------------
Country | MX
-----------------------------------------------------
Telephone | 376-765-8200
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 11198
-----------------------------------------------------
City | FORT LAUDERDALE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33339-1198
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. ALBERTO MARRON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 376-765-8200
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 282N00000X
-----------------------------------------------------
Taxonomy Name | General Acute Care Hospital
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------