| Clinical Care Center, Inc. | |
|
11200 W. Flagler St. Suites 101-107 Miami FL 33174-4210 | |
| (305) 370-3838 | |
| (305) 220-3466 |
| Full Name | Clinical Care Center, Inc. |
|---|---|
| Speciality | General Practice |
| Location | 11200 W. Flagler St., Miami, Florida |
| Authorized Official Name and Position | Antonio Diaz (PRESIDENT) |
| Authorized Official Contact | 7866314336 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinical Care Center, Inc. 2121 Sw 3rd Ave Suite 500 Miami FL 33129 Ph: (786) 631-4336 | Clinical Care Center, Inc. 11200 W. Flagler St. Suites 101-107 Miami FL 33174-4210 Ph: (305) 370-3838 |
| NPI Number | 1457634115 |
|---|---|
| Provider Enumeration Date | 09/20/2011 |
| Last Update Date | 11/06/2019 |
| Medicare PECOS PAC ID | 2365739125 |
|---|---|
| Medicare Enrollment ID | O20160921002175 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457634115 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Jose Guillermo Alvarez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205873817 PECOS PAC ID: 4587643580 Enrollment ID: I20040911000009 |
| Provider Name | Jesus Ramon Rodriguez De La Torre |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861489726 PECOS PAC ID: 4385826361 Enrollment ID: I20110311000660 |
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