Provider Demographics
NPI:1528944980
Name:PANAMA CLINIC MEDICAL, S.A.
Entity type:Organization
Organization Name:PANAMA CLINIC MEDICAL, S.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:
Authorized Official - First Name:THEODORO
Authorized Official - Middle Name:
Authorized Official - Last Name:CONSTANTINAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-310-1111
Mailing Address - Street 1:PO BOX 11661
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33339-1661
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CENTRO PACIFIC CENTER TORRE B
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:PAITILLA
Practice Address - Zip Code:99999
Practice Address - Country:PA
Practice Address - Phone:507-310-1111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access