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General NPI Number Information
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NPI Number | 1922697150
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Entity Type | Organization
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Legal Business Name | INTEGRITY CLINICAL MEDICAL CENTER INC
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Dates
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Enumeration Date | 01/12/2021
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 7590 NW 186 ST SUITE 209
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City | MIAMI
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State | FL
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Zip | 33015
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Country | US
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Telephone | 786-953-6263
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Fax | 786-953-6891
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Provider Business Mailing Address
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Address Line | 7590 NW 186 ST SUITE 209
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City | MIAMI
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State | FL
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Zip | 33015
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Country | US
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Telephone | 786-953-6263
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Fax | 786-953-6891
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Authorized Official
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Title or Position | PRESIDENT
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Name | CARLOS MAZA
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Credential | APRN
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Telephone | 786-953-6263
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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