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Organization
GUADALUPE LLC
Active
Organization
GUADALUPE LLC
Active
Other names
CLINICA LATINA
Organization subpart
No
Provider details
NPI number
Authorized official
SILVANA CAMPOS ECT (MANAGER)
(404) 492-2093
Entity
Organization
Contact information
Practice address
696 WINDY HILL RD SE, SMYRNA, GA 30080-1857
(404) 492-2093
Mailing address
696 WINDY HILL RD SE, SMYRNA, GA 30080-1857
(404) 492-2093
Taxonomy
Speciality
Code
Description
License number
State
202C00000X
Independent Medical Examiner Physician
—
NULL
202C00000X
Independent Medical Examiner Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
NULL
Other
Enumeration date
02/23/2023
Last updated
02/23/2023
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