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General NPI Number Information
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NPI Number | 1821743022
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Entity Type | Organization
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Legal Business Name | CLINIC ASSOCIATES INC
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Dates
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Enumeration Date | 02/16/2022
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Last Update Date | 02/16/2022
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Provider Practice Location Address
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Address Line | 6836 BIRD RD STE B
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City | MIAMI
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State | FL
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Zip | 33155-3708
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Country | US
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Telephone | 305-783-2033
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Fax | 786-655-0320
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Provider Business Mailing Address
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Address Line | 7015 SW 19TH TER
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City | MIAMI
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State | FL
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Zip | 33155-1616
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Country | US
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Telephone | 305-776-7254
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANTONIO JAVIER DIAZ SOCARRAS
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Credential | APRN
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Telephone | 305-776-7254
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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