Organization
CLINICA MEDICA DEL CANYON GATE
Active
Organization
CLINICA MEDICA DEL CANYON GATE
Active
Other names
canyon gate medical group
Organization subpart
No
Provider details
NPI number
Authorized official
VERONICA COLON (CREDENTIALING COORDINATOR)
(954) 656-8855
Entity
Organization
Contact information
Practice address
2832 E LAKE MEAD BLVD, SUITE# E, NORTH LAS VEGAS, NV 89030-6550
(702) 649-5155
Mailing address
2929 N UNIVERSITY DR, SUITE# 110, CORAL SPRINGS, FL 33065-5081
(954) 656-8855
(954) 656-8856
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
12464
NV
Other
Enumeration date
12/02/2010
Last updated
12/02/2010
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