Provider Demographics
NPI:1184388738
Name:CMQ HOSPITALS
Entity type:Organization
Organization Name:CMQ HOSPITALS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:ALEX
Authorized Official - Last Name:VILLANUEVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:322-226-6500
Mailing Address - Street 1:HOSPITAL CMQ
Mailing Address - Street 2:1400 VILLAGE SQUARE BLVD #3-80638
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32312
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:HOSPITAL CMQ
Practice Address - Street 2:AV. FRANCISCO VILLA 1749 VALLARTA VILLAS
Practice Address - City:PUERTO VALLARTA
Practice Address - State:JALISCO
Practice Address - Zip Code:48300
Practice Address - Country:MX
Practice Address - Phone:322-226-6500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-28
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NOM-004-SSA3-2012OtherSTATE