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General NPI Number Information
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NPI Number | 1891317806
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Entity Type | Organization
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Legal Business Name | SOCORRO HEALTH LLC
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Dates
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Enumeration Date | 05/13/2020
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Last Update Date | 11/29/2022
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Provider Practice Location Address
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Address Line | 777 E 25TH ST STE 308
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City | HIALEAH
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State | FL
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Zip | 33013-3824
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Country | US
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Telephone | 954-696-3093
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Fax | 305-995-0947
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Provider Business Mailing Address
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Address Line | 10640 SW 20TH CT
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City | MIRAMAR
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State | FL
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Zip | 33025-3963
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Country | US
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Telephone | 954-696-3093
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CIOMARA SOCORRO
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Credential | ARNP
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Telephone | 954-696-3093
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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