Provider Demographics
NPI:1952509549
Name:EL COBRE MEDICAL CENTER INC
Entity Type:Organization
Organization Name:EL COBRE MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:REINALDO
Authorized Official - Middle Name:
Authorized Official - Last Name:LARROQUE GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-261-9970
Mailing Address - Street 1:5829 SW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-5035
Mailing Address - Country:US
Mailing Address - Phone:305-261-9970
Mailing Address - Fax:
Practice Address - Street 1:5829 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:WEST MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-5035
Practice Address - Country:US
Practice Address - Phone:305-261-9970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty