MEDICARE: CLINICA VENAMER LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QM1200X	Magnetic Resonance Imaging (MRI) Clinic/Center
2	261QR0206X	Mammography Clinic/Center
3	261QR0200X	Radiology Clinic/Center

General Provider Information

NPI Number	:	1598019770
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLINICA VENAMER LLC

Provider Business Mailing Address
First Line	:	1757 CORAL WAY
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33145-2728
Country	:	US
Telephone Number	:	786-442-1040
Fax Number	:

Provider Business Practice Location Address
First Line	:	1757 CORAL WAY
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33145-2728
Country	:	US
Telephone Number	:	786-442-1040
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	GIANPAOLO BELMONTE
Credential	:
Telephone Number	:	305-482-9556

Provider Enumeration Date	:	11/09/2012
Last Update Date	:	11/09/2012

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