Provider Demographics
NPI:1740778877
Name:PARAISO MEDICAL AND RESEARCH CENTER, LLC.
Entity Type:Organization
Organization Name:PARAISO MEDICAL AND RESEARCH CENTER, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPINOZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-655-0095
Mailing Address - Street 1:85 GRAND CANAL DR STE 104
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2566
Mailing Address - Country:US
Mailing Address - Phone:786-655-0095
Mailing Address - Fax:
Practice Address - Street 1:85 GRAND CANAL DR STE 104
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2566
Practice Address - Country:US
Practice Address - Phone:786-655-0095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-24
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty