Provider Demographics
NPI:1851621155
Name:COMODIN CORP
Entity Type:Organization
Organization Name:COMODIN CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMALIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUERREIRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-287-5665
Mailing Address - Street 1:5603 NW 112TH PL
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-3849
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5603 NW 112TH PL
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-3849
Practice Address - Country:US
Practice Address - Phone:786-287-5665
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-08
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain