Provider Demographics
NPI:1861116816
Name:INTERNATIONAL MEDICAL GROUP INTERMDGROUP S.R.L.
Entity type:Organization
Organization Name:INTERNATIONAL MEDICAL GROUP INTERMDGROUP S.R.L.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:A
Authorized Official - Last Name:PRATO ZULUAGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-526-9751
Mailing Address - Street 1:PO BOX 39192
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33339-9192
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:BOULEVARD TURISTICO DEL ESTE, ESQ. COCOTAL
Practice Address - Street 2:
Practice Address - City:BAVARO
Practice Address - State:PUNTA CANA
Practice Address - Zip Code:23000
Practice Address - Country:DO
Practice Address - Phone:809-285-6116
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital