Provider Demographics
NPI:1467834028
Name:MEDICAL CLINIC SERVICES CORP
Entity Type:Organization
Organization Name:MEDICAL CLINIC SERVICES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HUMBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-275-4888
Mailing Address - Street 1:2955 SW 8TH ST STE 203
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-2864
Mailing Address - Country:US
Mailing Address - Phone:786-275-4888
Mailing Address - Fax:786-275-4847
Practice Address - Street 1:2955 SW 8TH ST STE 203
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-2864
Practice Address - Country:US
Practice Address - Phone:786-275-4888
Practice Address - Fax:786-275-4847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-19
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty