Healthcare Provider Details

I. General information

NPI: 1629651211
Provider Name (Legal Business Name): CLINICA PICRIN OF MIAMI,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2021
Last Update Date: 04/30/2021
Certification Date: 04/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

780 NE 69TH ST STE 203
MIAMI FL
33138-5751
US

IV. Provider business mailing address

780 NE 69TH ST STE 203
MIAMI FL
33138-5751
US

V. Phone/Fax

Practice location:
  • Phone: 786-651-8092
  • Fax:
Mailing address:
  • Phone: 786-651-8092
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARTIN NEAL ZAIAC
Title or Position: PRESIDENT
Credential: MD
Phone: 786-651-8092