Carmen A Sierra Md Mg Llc

NPI 1124410014 - Family Medicine - 207Q00000X

NPI Details
NPI 1124410014
Enumeration Date 03/02/2015
Last Updated 03/02/2015
Entity Type Healthcare Provider
Active Over 1 year ago
Authorized Information
Name CARMEN A CARMEN
Position OWNER
Phone (773) 425-3525
Fax
Practice Location
7459 GATHERING LOOP
REUNION FL, 34747-3128, US
Phone (773) 425-3525
Fax
Business Location
7459 GATHERING LOOP
REUNION FL, 34747-3128, US
Phone
Fax
Toxanomy
Taxonomy Code 207Q00000X
License State Illinois
License Number 036094303
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According to our database, Carmen A Sierra Md Mg Llc NPI is 1124410014, taxonomy code is 207Q00000X and license number is 036094303, license state is located at Illinois. Carmen A Sierra Md Mg Llc physically located at 7459 Gathering Loop, Reunion FL, 34747-3128. NPI Number 1033115704 has the healthcare provider type.

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1124410014 NPI number is provided on an as is basis without warranty of any kind. 1124410014 is maintained by the National Plan & Provider Enumeration System. The contents of Carmen A Sierra Md Mg Llc are for informational purposes only.