Organization
SANTA ROSA MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SERGIO EDGARDO ABRIOLA MD (MEDICAL DOCTOR)
(505) 472-4311
Entity
Organization
Contact information
Practice address
533 LAKE DR, SANTA ROSA, NM 88435
(505) 472-4311
(505) 472-4313
Mailing address
533 LAKE DR, SANTA ROSA, NM 88435
(505) 472-4311
(505) 472-4313
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20020002
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
78150728
—
NM
Enumeration date
07/06/2006
Last updated
08/22/2020
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