Provider Demographics
NPI:1598995540
Name:DEL SOL OUTPATIENT MEDICAL CENTER CORP
Entity Type:Organization
Organization Name:DEL SOL OUTPATIENT MEDICAL CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALFREDO
Authorized Official - Middle Name:
Authorized Official - Last Name:MACHADO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-301-5445
Mailing Address - Street 1:9001 CASHEW DR
Mailing Address - Street 2:STE 900
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79907-2967
Mailing Address - Country:US
Mailing Address - Phone:786-301-5445
Mailing Address - Fax:305-388-4380
Practice Address - Street 1:9001 CASHEW DR
Practice Address - Street 2:STE 900
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79907-2967
Practice Address - Country:US
Practice Address - Phone:786-301-5445
Practice Address - Fax:305-388-4380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-23
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME86567208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty