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GUADALUPE MEDICAL CENTER INC NPI 1861504342


NPI Information

NPI: 1861504342
Provider Name: GUADALUPE MEDICAL CENTER INC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 10D1036803

Address:
4469 S CONGRESS AVE STE 106
LAKE WORTH, FL
ZIP 33461
Phone: (561) 642-0768
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GUADALUPE MEDICAL CENTER INC is a family medicine in Lake Worth, FL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. GUADALUPE MEDICAL CENTER INC NPI is 1861504342. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4469 S CONGRESS AVE STE 106
LAKE WORTH, FL
ZIP 33461-726
Phone: (561) 642-0768
Fax: (561) 642-0769

The provider's authorized official is Olga Virginia Rosazza .
The authorized official title is Office Manager and has the following contact phone number (561) 642-0768.

The CLIA number assigned to this NPI record is 10D1036803 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/31/2006 and was last updated on 10/5/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1K6049MEDICARE ID-TYPE UNSPECIFIEDFLORIDA
2269435200MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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