Provider Demographics
NPI:1275298044
Name:HEALTH ACCESS CLINIC
Entity Type:Organization
Organization Name:HEALTH ACCESS CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:
Authorized Official - First Name:RICHARDSON
Authorized Official - Middle Name:
Authorized Official - Last Name:MOTHERSIL
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:786-991-8905
Mailing Address - Street 1:1005 NE 125TH ST STE 202
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-5858
Mailing Address - Country:US
Mailing Address - Phone:305-927-3777
Mailing Address - Fax:
Practice Address - Street 1:1005 NE 125TH ST STE 202
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-5858
Practice Address - Country:US
Practice Address - Phone:305-927-3777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-05
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty