# MOSAIC MD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760007801
- **Authorized official:** DR. GLORIA IVETTE RODRIGUEZ CUADRADO MD (OWNER)
- **Authorized official phone:** (405) 369-8282

## Contact information

- **Practice address:** 1401 N LELIA ST, GUYMON, OK 73942-3371
- **Practice address phone:** (405) 369-8282
- **Practice address fax:** (425) 250-8291
- **Mailing address:** PO BOX 350, GUYMON, OK 73942-0350
- **Mailing address phone:** (405) 369-8282
- **Mailing address fax:** (425) 250-8291

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/15/2020
- **Last updated:** 06/16/2020