Provider Demographics
NPI:1447073184
Name:ATHENA CLINICAL RESEARCH LLC
Entity type:Organization
Organization Name:ATHENA CLINICAL RESEARCH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DALY
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ DURAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-445-3311
Mailing Address - Street 1:2048 OPA LOCKA BLVD
Mailing Address - Street 2:
Mailing Address - City:OPA LOCKA
Mailing Address - State:FL
Mailing Address - Zip Code:33054-4228
Mailing Address - Country:US
Mailing Address - Phone:786-391-1733
Mailing Address - Fax:786-206-7042
Practice Address - Street 1:2048 OPA LOCKA BLVD
Practice Address - Street 2:
Practice Address - City:OPA LOCKA
Practice Address - State:FL
Practice Address - Zip Code:33054-4228
Practice Address - Country:US
Practice Address - Phone:786-391-1733
Practice Address - Fax:786-206-7042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-01
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch