| Clinical Care Services, Inc. | |
|
3091 Coral Way Miami FL 33145 | |
| (305) 649-6077 | |
| (305) 649-6071 |
| Full Name | Clinical Care Services, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 3091 Coral Way, 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 Services, Inc. 2121 Sw 3rd Ave Suite 500 Miami FL 33129 Ph: (786) 631-4336 | Clinical Care Services, Inc. 3091 Coral Way Miami FL 33145 Ph: (305) 649-6077 |
| NPI Number | 1922111590 |
|---|---|
| Provider Enumeration Date | 08/16/2006 |
| Last Update Date | 12/02/2019 |
| Medicare PECOS PAC ID | 5597757476 |
|---|---|
| Medicare Enrollment ID | O20040331001299 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922111590 | NPI | - | NPPES |
| 010301300 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| Provider Name | Ernesto Diaz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457397507 PECOS PAC ID: 1153313929 Enrollment ID: I20040401000217 |
| Provider Name | Diego F Montes |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1649660697 PECOS PAC ID: 5193014454 Enrollment ID: I20160510002065 |
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