Provider Demographics
NPI:1447662721
Name:AMERICA CLINIC CENTER INC
Entity type:Organization
Organization Name:AMERICA CLINIC CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARIDAD
Authorized Official - Middle Name:
Authorized Official - Last Name:CEBALLOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-703-2224
Mailing Address - Street 1:8260 W FLAGLER ST
Mailing Address - Street 2:SUITE 2-K
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2069
Mailing Address - Country:US
Mailing Address - Phone:786-703-2224
Mailing Address - Fax:786-703-2212
Practice Address - Street 1:8260 W FLAGLER ST
Practice Address - Street 2:SUITE 2-K
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2069
Practice Address - Country:US
Practice Address - Phone:786-703-2224
Practice Address - Fax:786-703-2212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-21
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty