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General NPI Number Information
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NPI Number | 1942142872
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Entity Type | Organization
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Legal Business Name | DADE FLORIDA CLINICAL RESEARCH CENTER LLC
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Dates
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Enumeration Date | 04/08/2026
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Last Update Date | 04/08/2026
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Provider Practice Location Address
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Address Line | 7100 SW 99TH AVE STE 204
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City | MIAMI
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State | FL
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Zip | 33173-4668
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Country | US
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Telephone | 786-457-0768
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Fax | 305-456-4996
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Provider Business Mailing Address
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Address Line | 7100 SW 99TH AVE STE 204
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City | MIAMI
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State | FL
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Zip | 33173-4668
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Country | US
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Telephone | 786-457-0768
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Fax | 305-456-4996
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Authorized Official
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Title or Position | OWNER
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Name | RAIDY RICHARD CONCEPCION GOMEZ
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Credential |
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Telephone | 786-457-0768
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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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