| Organization Name: | CENTRO PRENATAL DE GEORGIA |
| NPI Number: | 1073918207 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROSALBA GOMEZ (OFFICE MANAGER) |
| Mailing Address: | 4990 Phillips Dr Forest Park |
| State: | GA US |
| Postal Code: | 302971472 |
| Phone Number: | 4046087449 |
| Fax Number: | 4046087451 |
| NPI Enumeration Date: | 10/30/2014 |
| NPI Last Update Date: | 10/30/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SW0102X |
| License Number: | RN1185224NP |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Women's Health |
| Taxonomy Definition: | |