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Organization
GUADALUPE MEDICAL CENTER INC
Active
Organization
GUADALUPE MEDICAL CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. OLGA VIRGINIA ROSAZZA (OFFICE MANAGER)
(561) 642-0768
Entity
Organization
Contact information
Practice address
4469 S CONGRESS AVE STE 106, LAKE WORTH, FL 33461-4726
(561) 642-0768
(561) 642-0769
Mailing address
4469 S CONGRESS AVE STE 106, LAKE WORTH, FL 33461-4726
(561) 642-0768
(561) 642-0769
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
269435200
—
FL
Enumeration date
08/31/2006
Last updated
10/05/2012
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