1063910230 NPI number — SERVICIOS MEDICOS PARA TODOS S.A. DE C.V.

Table of content: (NPI 1063910230)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063910230 NPI number — SERVICIOS MEDICOS PARA TODOS S.A. DE C.V.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SERVICIOS MEDICOS PARA TODOS S.A. DE C.V.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
UNIDAD MEDICO QUIRURGICA DEL SUR
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1063910230
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/16/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 11577
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT LAUDERDALE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33339-1577
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
872-874 AV. LOPEZ PORTILLO SM 59 MZ 37
Provider Second Line Business Practice Location Address:
UNIDAD MORELOS ENTRE AV. KABAH Y AV. COMALCALCO
Provider Business Practice Location Address City Name:
CANCUN
Provider Business Practice Location Address State Name:
QUINTANA ROO
Provider Business Practice Location Address Postal Code:
77515
Provider Business Practice Location Address Country Code:
MX
Provider Business Practice Location Address Telephone Number:
998-843-5454
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/23/2018

Additional Information

Authorized Official

Authorized Official Last Name:
GARRIDO HERNANDEZ
Authorized Official First Name:
JUAN
Authorized Official Middle Name:
CARLOS
Authorized Official Title or Position:
SERVICIO AL PACIENTE
Authorized Official Telephone Number:
954-903-7445

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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