1053560912 NPI number — CLINICA HEMATO ONCOLOGICA, S.A.

Table of content: (NPI 1053560912)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053560912 NPI number — CLINICA HEMATO ONCOLOGICA, S.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CLINICA HEMATO ONCOLOGICA, S.A.
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:
Provider Other Organization Name Type Code:
6
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:
1053560912
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/16/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CL.53 MARBELLA
Provider Second Line Business Mailing Address:
EDIF ROYAL CENTER PISO 5
Provider Business Mailing Address City Name:
PANAMA
Provider Business Mailing Address State Name:
PANAMA
Provider Business Mailing Address Postal Code:
00832
Provider Business Mailing Address Country Code:
PA
Provider Business Mailing Address Telephone Number:
507-265-2232
Provider Business Mailing Address Fax Number:
507-264-6791

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CL.53 MARBELLA
Provider Second Line Business Practice Location Address:
EDIF ROYAL CENTER PISO 5
Provider Business Practice Location Address City Name:
PANAMA
Provider Business Practice Location Address State Name:
PANAMA
Provider Business Practice Location Address Postal Code:
00832
Provider Business Practice Location Address Country Code:
PA
Provider Business Practice Location Address Telephone Number:
507-265-2232
Provider Business Practice Location Address Fax Number:
507-264-6791
Provider Enumeration Date:
09/16/2008

Additional Information

Authorized Official

Authorized Official Last Name:
ROBINSON
Authorized Official First Name:
JULIE
Authorized Official Middle Name:
C
Authorized Official Title or Position:
ADMINISTRATIVE
Authorized Official Telephone Number:
507-265-2232

Provider Taxonomy Codes

  • Taxonomy code: 261QI0500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QX0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QX0203X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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