Provider Demographics
NPI:1497234512
Name:FXM CLINICAL RESEARCH MIAMI LLC
Entity Type:Organization
Organization Name:FXM CLINICAL RESEARCH MIAMI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARITZA
Authorized Official - Middle Name:D
Authorized Official - Last Name:DIEGO
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:305-220-5222
Mailing Address - Street 1:11760 BIRD RD STE 452
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3598
Mailing Address - Country:US
Mailing Address - Phone:305-220-5222
Mailing Address - Fax:305-675-3152
Practice Address - Street 1:11760 BIRD RD STE 452
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3598
Practice Address - Country:US
Practice Address - Phone:305-220-5222
Practice Address - Fax:305-675-3152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9110219261QR1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch