MEDICARE: NAVSTA PRIMARY CARE CLINIC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist		IL

General Provider Information

NPI Number	:	1518135573
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NAVSTA PRIMARY CARE CLINIC

Provider Business Mailing Address
First Line	:	3116 3RD FLOOR FESTIVAL SUPERMALL
Second Line	:	FILINVEST CORP.CITY
City	:	ALABANG MUNTINLUPA
State	:	MANILA
Zip	:	1740
Country	:	PH
Telephone Number	:	632-809-2736
Fax Number	:	632-809-2736

Provider Business Practice Location Address
First Line	:	3116 3RD FLOOR FESTIVAL SUPERMALL
Second Line	:	FILINVEST CORP. CITY
City	:	ALABANG MUNTINLUPA
State	:	MANILA
Zip	:	1740
Country	:	PH
Telephone Number	:	632-809-2736
Fax Number	:	632-809-2736

Authorized Official
Title or Position	:	CLINIC MANAGER
Name	:	MRS. IRENE SIMON CORTEZ
Credential	:
Telephone Number	:	632-809-2736

Provider Enumeration Date	:	02/13/2008
Last Update Date	:	02/13/2008

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Directions to “NAVSTA PRIMARY CARE CLINIC ” Practice Location

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