Healthcare Provider Details

I. General information

NPI: 1528934064
Provider Name (Legal Business Name): PA HEALTH & RESEARCH CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2025
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 SW 107TH AVE STE 202
MIAMI FL
33176-1451
US

IV. Provider business mailing address

8900 SW 107TH AVE STE 202
MIAMI FL
33176-1451
US

V. Phone/Fax

Practice location:
  • Phone: 786-857-1902
  • Fax:
Mailing address:
  • Phone: 786-857-1902
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744R1102X
TaxonomyResearch Study Specialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code246QL0900X
TaxonomyLaboratory Management Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: YARIELYS ACOSTA
Title or Position: SITE DIRECTOR
Credential:
Phone: 786-857-1902