Provider Demographics
NPI:1982031795
Name:LATINO CARE, LLC
Entity Type:Organization
Organization Name:LATINO CARE, LLC
Other - Org Name:CLINICA MEDICA HISPANA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:J
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-353-6656
Mailing Address - Street 1:3140 N 35TH AVE
Mailing Address - Street 2:SUITE 7
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85017-5270
Mailing Address - Country:US
Mailing Address - Phone:602-353-6656
Mailing Address - Fax:602-442-2065
Practice Address - Street 1:3140 N 35TH AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85017-5270
Practice Address - Country:US
Practice Address - Phone:602-353-6656
Practice Address - Fax:602-442-2065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-11
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ20754208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty