Mosaic Md | |
1401 N Lelia St Guymon OK 73942-3371 | |
(405) 369-8282 | |
(425) 250-8291 |
Full Name | Mosaic Md |
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Speciality | General Practice |
Location | 1401 N Lelia St, Guymon, Oklahoma |
Authorized Official Name and Position | Gloria Ivette Rodriguez Cuadrado (OWNER) |
Authorized Official Contact | 4053698282 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Mosaic Md Po Box 350 Guymon OK 73942-0350 Ph: (405) 369-8282 | Mosaic Md 1401 N Lelia St Guymon OK 73942-3371 Ph: (405) 369-8282 |
NPI Number | 1760007801 |
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Provider Enumeration Date | 06/15/2020 |
Last Update Date | 06/16/2020 |
Medicare PECOS PAC ID | 2062834203 |
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Medicare Enrollment ID | O20200617001680 |
Identifier | Type | State | Issuer |
---|---|---|---|
1760007801 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | (* (Not Available)) | Primary |
Provider Name | Gloria Ivette Rodriguez-cuadrado |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1861700841 PECOS PAC ID: 7911209994 Enrollment ID: I20181219002173 |
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