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General NPI Number Information
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NPI Number | 1982855359
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Entity Type | Organization
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Legal Business Name | DEL PRADO MEDICAL CENTER INC
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Dates
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Enumeration Date | 10/03/2008
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Last Update Date | 07/29/2024
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Provider Practice Location Address
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Address Line | 2500 DEL PRADO BLVD S
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City | CAPE CORAL
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State | FL
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Zip | 33904-5750
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Country | US
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Telephone | 239-772-1194
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Fax | 239-772-1196
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Provider Business Mailing Address
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Address Line | 2500 DEL PRADO BLVD S
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City | CAPE CORAL
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State | FL
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Zip | 33904-5750
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Country | US
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Telephone | 239-772-1194
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Fax | 239-772-1196
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DAISY MARTINEZ
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Credential |
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Telephone | 239-772-1194
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | 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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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