Provider Demographics
NPI:1467930941
Name:CLINICA LAS MERCEDES, LLC
Entity Type:Organization
Organization Name:CLINICA LAS MERCEDES, LLC
Other - Org Name:LAS MERCEDES MEDICAL CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:RAAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-233-6981
Mailing Address - Street 1:6355 NW 36TH ST BLDG STE 1100
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33166-7009
Mailing Address - Country:US
Mailing Address - Phone:786-233-6981
Mailing Address - Fax:786-322-2317
Practice Address - Street 1:11701 SW 147TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-3312
Practice Address - Country:US
Practice Address - Phone:786-953-8200
Practice Address - Fax:786-953-8647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-06
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty