Provider Demographics
NPI:1073149100
Name:PAN AMERICAN MEDICAL CENTER, CORP
Entity Type:Organization
Organization Name:PAN AMERICAN MEDICAL CENTER, CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:ERNESTO
Authorized Official - Last Name:ALEGRET
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-772-2255
Mailing Address - Street 1:PO BOX 440919
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-0919
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7171 SW 24TH ST STE 311
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-1692
Practice Address - Country:US
Practice Address - Phone:305-221-0200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-20
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center