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General NPI Number Information
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NPI Number | 1144024936
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Entity Type | Organization
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Legal Business Name | CLAREMEDICA VIKING LLC
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Dates
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Enumeration Date | 04/02/2025
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 1757 SW 22ND STREET
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City | MIAMI
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State | FL
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Zip | 33145
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Country | US
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Telephone | 786-442-1040
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Fax |
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Provider Business Mailing Address
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Address Line | 14750 NW 77TH CT STE 100
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City | MIAMI LAKES
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State | FL
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Zip | 33016-1507
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Country | US
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Telephone | 786-758-3165
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MARK L MULLINIX
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Credential |
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Telephone | 786-758-3135
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number |
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License Number State |
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