Provider Demographics
NPI:1497096861
Name:NOSTRUM MEDICAL CENTER US-1 LLC
Entity Type:Organization
Organization Name:NOSTRUM MEDICAL CENTER US-1 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:F
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-210-1499
Mailing Address - Street 1:27531 S DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-8225
Mailing Address - Country:US
Mailing Address - Phone:786-210-1499
Mailing Address - Fax:888-266-9406
Practice Address - Street 1:27531 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-8225
Practice Address - Country:US
Practice Address - Phone:786-210-1499
Practice Address - Fax:888-266-9406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-11
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty