Provider Demographics
NPI:1245811348
Name:CLINICA LAS MERCEDES, LLC
Entity type:Organization
Organization Name:CLINICA LAS MERCEDES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:RAAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-233-6981
Mailing Address - Street 1:6355 NW 36TH ST BLDG STE 1100
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33166-7009
Mailing Address - Country:US
Mailing Address - Phone:786-233-6981
Mailing Address - Fax:786-322-2317
Practice Address - Street 1:428 NE 125TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-4717
Practice Address - Country:US
Practice Address - Phone:305-570-0012
Practice Address - Fax:305-351-9087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-20
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty