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General NPI Number Information
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NPI Number | 1003973751
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Entity Type | Organization
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Legal Business Name | THE PERSONAL INJURY CLINIC INC
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 01/13/2009
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Provider Practice Location Address
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Address Line | 900 W 49TH ST SUITE 304
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City | HIALEAH
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State | FL
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Zip | 33012-3402
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Country | US
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Telephone | 305-823-3131
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Fax | 305-558-4267
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Provider Business Mailing Address
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Address Line | 900 W 49TH ST SUITE 304
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City | HIALEAH
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State | FL
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Zip | 33012-3402
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Country | US
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Telephone | 305-823-3131
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Fax | 305-558-4267
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Authorized Official
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Title or Position | PRESIDENT
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Name | RAUL MARTINEZ
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Credential |
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Telephone | 305-823-3131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | HCC6839
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License Number State | FL
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