Provider Demographics
NPI:1578330619
Name:LATINO CONNECTION
Entity Type:Organization
Organization Name:LATINO CONNECTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-963-7218
Mailing Address - Street 1:940 E PARK DR
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-2800
Mailing Address - Country:US
Mailing Address - Phone:717-963-7218
Mailing Address - Fax:
Practice Address - Street 1:940 E PARK DR
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17111-2800
Practice Address - Country:US
Practice Address - Phone:717-963-7218
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-08
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier