Provider Demographics
NPI:1144927047
Name:CIELO MEDICA
Entity type:Organization
Organization Name:CIELO MEDICA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:
Authorized Official - Last Name:AMORES
Authorized Official - Suffix:
Authorized Official - Credentials:DMSC, PA-C
Authorized Official - Phone:248-230-9667
Mailing Address - Street 1:28475 GREENFIELD RD
Mailing Address - Street 2:STE 113 PMB 11918
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076
Mailing Address - Country:US
Mailing Address - Phone:248-230-9660
Mailing Address - Fax:248-230-9661
Practice Address - Street 1:28475 GREENFIELD RD
Practice Address - Street 2:STE 113 PMB 11918
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076
Practice Address - Country:US
Practice Address - Phone:248-230-9660
Practice Address - Fax:248-230-9661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-10
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service