Provider Demographics
NPI:1134349483
Name:CONTINUCARE CLINICS, INC.
Entity type:Organization
Organization Name:CONTINUCARE CLINICS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT OF OPERATI
Authorized Official - Prefix:MS
Authorized Official - First Name:GEMMA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSELLO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:305-500-2000
Mailing Address - Street 1:7200 NW 19TH ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-1200
Mailing Address - Country:US
Mailing Address - Phone:305-500-2009
Mailing Address - Fax:305-500-2145
Practice Address - Street 1:AT SEDANO'S PHARMACY
Practice Address - Street 2:11865-A S.W. 26 STREET
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175
Practice Address - Country:US
Practice Address - Phone:305-500-2009
Practice Address - Fax:305-500-2145
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CONTINUCARE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-27
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherEIN