California Club Diagnostics Center, LLC.
Family Medicine in North Miami Beach, FL. Organization (NPI-2).
NPI number1851400931
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1851400931
- Entity type
- Organization (NPI-2)
- Legal business name
- California Club Diagnostics Center, LLC.
- Organization subpart
- No
- Enumeration date
- Aug 30, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Practice location
850 Ives Dairy Rd Unit 14North Miami Beach, FL 33179-2450
Phone 305-405-0365 · Fax 305-405-0370
Mailing address
850 Ives Dairy Rd Unit 14North Miami Beach, FL 33179-2450
Phone 305-405-0365 · Fax 305-405-0370
Authorized official
Alexander Baronov
President
3054050365
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