# CLINICA SANTA MARIA 2, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Clinica Santa Maria 2, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871934323
- **Authorized official:** MR. ANTONIO MENDOZA (OFFICE MANAGER)
- **Authorized official phone:** (770) 928-8450

## Contact information

- **Practice address:** 6158 HIGHWAY 92 STE 101, ACWORTH, GA 30102-2332
- **Practice address phone:** (770) 928-8450
- **Practice address fax:** (770) 928-8452
- **Mailing address:** 6158 HIGHWAY 92 STE 101, ACWORTH, GA 30102-2332
- **Mailing address phone:** (770) 928-8450
- **Mailing address fax:** (770) 928-8452

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | — |

## Other

- **Enumeration date:** 07/12/2013
- **Last updated:** 07/12/2013