| Sunland Clinic Llc | |
|
1155 Mcnutt Rd Ste 104 Sunland Park NM 88063-9176 | |
| (915) 202-4463 | |
| Not Available |
| Full Name | Sunland Clinic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1155 Mcnutt Rd Ste 104, Sunland Park, New Mexico |
| Authorized Official Name and Position | Mindy Villa (PRESIDENT) |
| Authorized Official Contact | 9152024463 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunland Clinic Llc 1155 Mcnutt Rd Ste 104 Sunland Park NM 88063-9176 Ph: (915) 202-4463 | Sunland Clinic Llc 1155 Mcnutt Rd Ste 104 Sunland Park NM 88063-9176 Ph: (915) 202-4463 |
| NPI Number | 1518607258 |
|---|---|
| Provider Enumeration Date | 03/30/2022 |
| Last Update Date | 01/25/2023 |
| Medicare PECOS PAC ID | 5193190775 |
|---|---|
| Medicare Enrollment ID | O20230413000201 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518607258 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Mindy Estella Solano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558801308 PECOS PAC ID: 9830430248 Enrollment ID: I20230413000211 |
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