Organization
LA CLINICA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIE E SATIZABAL (ADMINISTRATIVE ASSISTANT)
(843) 338-1598
Entity
Organization
Contact information
Practice address
157 WILLIAM HILTON PKWY, HILTON HEAD ISLAND, SC 29926-5218
(843) 338-1598
(843) 342-2710
Mailing address
PO BOX 23253, HILTON HEAD ISLAND, SC 29925-3253
(843) 338-1598
(843) 342-2710
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APN 1897
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APN 1897
MEDICAL LICENSE NUMBER
SC
Enumeration date
06/09/2010
Last updated
06/09/2010
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