Provider Demographics
NPI:1942996400
Name:BRAZILIAN CLINIC LLC
Entity Type:Organization
Organization Name:BRAZILIAN CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NEYMAR
Authorized Official - Middle Name:C
Authorized Official - Last Name:DE LIMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-210-0942
Mailing Address - Street 1:3402 N ANDREWS AVE EXT
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064
Mailing Address - Country:US
Mailing Address - Phone:954-368-1302
Mailing Address - Fax:954-656-3219
Practice Address - Street 1:3095 NE 163RD ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160
Practice Address - Country:US
Practice Address - Phone:786-702-7616
Practice Address - Fax:954-656-3219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center