MEDICARE: INTEGRITY CLINICAL RESEARCH CENTER INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR1100X	Research Clinic/Center

General Provider Information

NPI Number	:	1154879997
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRITY CLINICAL RESEARCH CENTER INC

Provider Business Mailing Address
First Line	:	7590 NW 186TH ST
Second Line	:	SUITE 209
City	:	HIALEAH
State	:	FL
Zip	:	33015-2952
Country	:	US
Telephone Number	:	786-953-6263
Fax Number	:	786-953-6891

Provider Business Practice Location Address
First Line	:	7590 NW 186TH ST
Second Line	:	SUITE 209
City	:	HIALEAH
State	:	FL
Zip	:	33015-2952
Country	:	US
Telephone Number	:	786-953-6263
Fax Number	:	786-953-6891

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. YAIMARY DIAZ
Credential	:
Telephone Number	:	786-953-6263

Provider Enumeration Date	:	09/21/2016
Last Update Date	:	09/21/2016

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