Provider Demographics
NPI:1770855595
Name:CENTRO MEDICO DR. CANELA, S.A.
Entity Type:Organization
Organization Name:CENTRO MEDICO DR. CANELA, S.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERTO
Authorized Official - Middle Name:A
Authorized Official - Last Name:MENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-931-1717
Mailing Address - Street 1:ESP R 599 P.O. BOX 025514
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33102
Mailing Address - Country:US
Mailing Address - Phone:407-931-1717
Mailing Address - Fax:407-931-2121
Practice Address - Street 1:AV. LBERTAD NO.44
Practice Address - Street 2:
Practice Address - City:LA ROMANA
Practice Address - State:LA ROMANA
Practice Address - Zip Code:NONE
Practice Address - Country:DO
Practice Address - Phone:809-556-3135
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-09
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital