Organization
CLINICA PANAMERICANA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HUGO F GOITIA MD (PRESIDENT)
(414) 389-0166
Entity
Organization
Contact information
Practice address
1225 W HISTORIC MITCHELL ST, 211, MILWAUKEE, WI 53204-3383
(414) 389-0166
(414) 643-1003
Mailing address
1225 W HISTORIC MITCHELL ST, 211, MILWAUKEE, WI 53204-3383
(414) 389-0166
(414) 643-1003
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
26560-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30639900
—
WI
Enumeration date
05/03/2011
Last updated
05/03/2011
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