Provider Demographics
NPI:1184234510
Name:MEDIPLUS CLINIC, INC.
Entity type:Organization
Organization Name:MEDIPLUS CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:LOSSAIRE
Authorized Official - Middle Name:
Authorized Official - Last Name:BIEN-AIME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-709-0665
Mailing Address - Street 1:151 S.W 6TH STREET
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33060
Mailing Address - Country:US
Mailing Address - Phone:954-532-3982
Mailing Address - Fax:954-206-2288
Practice Address - Street 1:151 S.W 6TH STREET
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33060
Practice Address - Country:US
Practice Address - Phone:954-532-3982
Practice Address - Fax:954-206-2288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-31
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center