Provider Demographics
NPI:1184021115
Name:BORROTO CLINIC AND TRANSPORTATION CORP
Entity Type:Organization
Organization Name:BORROTO CLINIC AND TRANSPORTATION CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BLANCA
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-764-8866
Mailing Address - Street 1:6850 SW 24TH ST STE 501
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-1763
Mailing Address - Country:US
Mailing Address - Phone:305-764-8866
Mailing Address - Fax:789-534-8718
Practice Address - Street 1:6850 SW 24TH ST STE 501
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-1763
Practice Address - Country:US
Practice Address - Phone:305-764-8866
Practice Address - Fax:789-534-8718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-19
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME106369261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service