Provider Demographics
NPI:1053453415
Name:CYL MEDICAL CENTER INC.
Entity Type:Organization
Organization Name:CYL MEDICAL CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CONSUELO
Authorized Official - Middle Name:
Authorized Official - Last Name:CORRECHET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-866-5880
Mailing Address - Street 1:1440 79TH STREET CSWY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:NORTH BAY VILLAGE
Mailing Address - State:FL
Mailing Address - Zip Code:33141-4188
Mailing Address - Country:US
Mailing Address - Phone:305-866-5880
Mailing Address - Fax:305-866-9441
Practice Address - Street 1:1440 79TH STREET CSWY
Practice Address - Street 2:SUITE 102
Practice Address - City:NORTH BAY VILLAGE
Practice Address - State:FL
Practice Address - Zip Code:33141-4188
Practice Address - Country:US
Practice Address - Phone:305-866-5880
Practice Address - Fax:305-866-9441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK8227Medicare ID - Type UnspecifiedMEDICARE