ADULT MEDICINE INSTITUTE & DIAGNOSTIC CENTER NPI 1578885240

NPI Information

NPI: 1578885240
Provider Name: ADULT MEDICINE INSTITUTE & DIAGNOSTIC CENTER
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 19D0972006

Address:
1937 S BURNSIDE AVE
GONZALES, LA
ZIP 70737
Phone: (225) 647-1947
Get Directions

ADULT MEDICINE INSTITUTE & DIAGNOSTIC CENTER is a primary care clinic center in Gonzales, LA. ADULT MEDICINE INSTITUTE & DIAGNOSTIC CENTER NPI is 1578885240. The provider is registered as an organization entity type.

The provider's business location address is:

1937 S BURNSIDE AVE
GONZALES, LA
ZIP 70737-632
Phone: (225) 647-1947
Fax: (225) 644-3943

The provider's authorized official is Carlos Ruben Vazquez .
The authorized official title is Owner and has the following contact phone number (225) 647-1947.

The CLIA number assigned to this NPI record is 19D0972006 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/23/2010 and was last updated on 2/23/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	022083	LOUISIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	G58731	MEDICARE UPIN	LOUISIANA
2	1495859	MEDICAID	LOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »