Provider Demographics
NPI:1013644335
Name:GLOBAL REACH HEALTH CLINIC LLC
Entity Type:Organization
Organization Name:GLOBAL REACH HEALTH CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:MR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:J
Authorized Official - Last Name:TALAMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MGR
Authorized Official - Phone:305-794-1375
Mailing Address - Street 1:9250 NW 25TH ST
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33172-1503
Mailing Address - Country:US
Mailing Address - Phone:305-424-7710
Mailing Address - Fax:305-560-5331
Practice Address - Street 1:9250 NW 25TH ST
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-1503
Practice Address - Country:US
Practice Address - Phone:305-424-7710
Practice Address - Fax:305-560-5331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-05
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service