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.
Organization
FIESTA PARK HEALTHCARE LLC
Active
Organization
FIESTA PARK HEALTHCARE LLC
Active
Other names
The Medical Resort at Fiesta Park
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT JEREMY MARTIN (CEO)
(505) 652-1985
Entity
Organization
Contact information
Practice address
8820 HORIZON BLVD NE, ALBUQUERQUE, NM 87113-1689
(505) 998-1551
Mailing address
8820 HORIZON BLVD NE, ALBUQUERQUE, NM 87113-1689
(505) 998-1551
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
17631823
—
NM
Enumeration date
10/11/2011
Last updated
12/10/2014
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers