Provider Demographics
NPI:1891122750
Name:CLINICAL CARE NETWORK, INC
Entity Type:Organization
Organization Name:CLINICAL CARE NETWORK, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-454-9844
Mailing Address - Street 1:2121 SW 3RD AVE
Mailing Address - Street 2:SUITE 500.
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33129-1490
Mailing Address - Country:US
Mailing Address - Phone:786-631-4335
Mailing Address - Fax:305-631-2806
Practice Address - Street 1:2121 SW 3RD AVE
Practice Address - Street 2:SUITE 500.
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33129-1490
Practice Address - Country:US
Practice Address - Phone:786-631-4335
Practice Address - Fax:305-631-2806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-08
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty