Provider Demographics
NPI:1609267277
Name:THE FLORIDA CLINIC, INC.
Entity Type:Organization
Organization Name:THE FLORIDA CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GUILLERMO
Authorized Official - Middle Name:
Authorized Official - Last Name:LUGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-300-8754
Mailing Address - Street 1:10000 SW 56TH ST STE 17
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-7162
Mailing Address - Country:US
Mailing Address - Phone:305-300-8754
Mailing Address - Fax:
Practice Address - Street 1:10000 SW 56TH ST STE 17
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-7162
Practice Address - Country:US
Practice Address - Phone:305-223-2436
Practice Address - Fax:305-223-2438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-18
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health