Provider Demographics
NPI:1477023273
Name:CIELO AZUL PROVIDER SERVICES, LLC.
Entity Type:Organization
Organization Name:CIELO AZUL PROVIDER SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-567-9711
Mailing Address - Street 1:3241 N. 38TH ST.
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501
Mailing Address - Country:US
Mailing Address - Phone:956-567-9711
Mailing Address - Fax:956-420-0444
Practice Address - Street 1:3241 N. 38TH ST.
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501
Practice Address - Country:US
Practice Address - Phone:956-567-9711
Practice Address - Fax:956-420-0444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-05
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty