Provider Demographics
NPI:1164259966
Name:CLINICA DE MEDICINA FAMILIAR DR. FRANKLIN PENA, S.R.L.
Entity type:Organization
Organization Name:CLINICA DE MEDICINA FAMILIAR DR. FRANKLIN PENA, S.R.L.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ESMERALDA
Authorized Official - Middle Name:
Authorized Official - Last Name:PENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-526-9751
Mailing Address - Street 1:PO BOX 11957
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33339-1957
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:AV. MAURICIO BAEZ
Practice Address - Street 2:
Practice Address - City:SAN PEDRO DE MACORIS
Practice Address - State:DOMINICAN REPUBLIC
Practice Address - Zip Code:21000
Practice Address - Country:DO
Practice Address - Phone:954-903-7445
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital