MEDICARE: CLAREMEDICA VIKING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332900000X	Non-Pharmacy Dispensing Site

General Provider Information

NPI Number	:	1437953148
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLAREMEDICA VIKING LLC

Provider Business Mailing Address
First Line	:	14750 NW 77TH CT STE 100
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33016-1507
Country	:	US
Telephone Number	:	786-758-3165
Fax Number	:

Provider Business Practice Location Address
First Line	:	9605-9607 WEST FLAGLER STREET
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33174
Country	:	US
Telephone Number	:	305-559-0278
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MARK L MULLINIX
Credential	:
Telephone Number	:	786-758-3135

Provider Enumeration Date	:	04/02/2025
Last Update Date	:	04/02/2025

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