Clinica Panamericana LLC

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

26560-20 Issued in WI

Legal business name

CLINICA PANAMERICANA LLC

Practice address

1225 W Historic Mitchell St
211
Milwaukee, WI 53204-3383

Phone

(414) 389-0166

Fax

(414) 643-1003

NPI assigned

May 3, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Hugo F Goitia, MD

Title

President

Phone

(414) 389-0166

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1304380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304380800000",
    "number": "1003108515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 W HISTORIC MITCHELL ST",
            "address_2": "211",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532043383",
            "telephone_number": "414-389-0166",
            "fax_number": "414-643-1003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 W HISTORIC MITCHELL ST",
            "address_2": "211",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532043383",
            "telephone_number": "414-389-0166",
            "fax_number": "414-643-1003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA PANAMERICANA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-03",
        "last_updated": "2011-05-03",
        "status": "A",
        "authorized_official_last_name": "GOITIA",
        "authorized_official_first_name": "HUGO",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-389-0166",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "WI",
            "license": "26560-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30639900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Cline, M.D.
• Clinic of Cosmetic Surgery SC
• Clinic of Urology SC
• Clinica Latina, S.C.
• Clinica Latina, SC
• Andrew Clithero, D.O.
• Kelsie Rae Closson
• Jeanne L Clow, O.T.
• Tina Cloyd-Brooks, APSW
• Anna Kathryn Cluskey, PA-C

• Point of Service in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Point of Service in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.