Provider Demographics
NPI:1821743022
Name:CLINIC ASSOCIATES INC
Entity Type:Organization
Organization Name:CLINIC ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:JAVIER
Authorized Official - Last Name:DIAZ SOCARRAS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:305-776-7254
Mailing Address - Street 1:7015 SW 19TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-1616
Mailing Address - Country:US
Mailing Address - Phone:305-776-7254
Mailing Address - Fax:
Practice Address - Street 1:6836 BIRD RD STE B
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-3708
Practice Address - Country:US
Practice Address - Phone:305-783-2033
Practice Address - Fax:786-655-0320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-16
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty