| Organization Name: | MARIPOSA COMMUNITY HEALTH CENTER |
| NPI Number: | 1013276161 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ED SICURELLO (CHIEF FINANCIAL OFFICER) |
| Mailing Address: | 1852 N Mastick Way Nogales |
| State: | AZ US |
| Postal Code: | 856211063 |
| Phone Number: | 5202811550 |
| Fax Number: | 5207612157 |
| NPI Enumeration Date: | 05/10/2012 |
| NPI Last Update Date: | 05/10/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085P0229X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Pediatric Radiology |
| Taxonomy Definition: | A radiologist who is proficient in all forms of diagnostic imaging as it pertains to the treatment of diseases in the newborn, infant, child and adolescent. This specialist has knowledge of both imaging and interventional procedures related to the care and management of diseases of children. A pediatric radiologist must be highly knowledgeable of all organ systems as they relate to growth and development, congenital malformations, diseases peculiar to infants and children and diseases that begin in childhood but cause substantial residual impairment in adulthood. |