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Organization
CLINICA SANTA MARIA 2, LLC
Active
Organization
CLINICA SANTA MARIA 2, LLC
Active
Other names
Clinica Santa Maria 2, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTONIO MENDOZA (OFFICE MANAGER)
(770) 928-8450
Entity
Organization
Contact information
Practice address
6158 HIGHWAY 92 STE 101, ACWORTH, GA 30102-2332
(770) 928-8450
(770) 928-8452
Mailing address
6158 HIGHWAY 92 STE 101, ACWORTH, GA 30102-2332
(770) 928-8450
(770) 928-8452
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
NULL
207V00000X
Obstetrics & Gynecology Physician
—
—
Other
Enumeration date
07/12/2013
Last updated
07/12/2013
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