Provider Demographics
NPI:1457775868
Name:MEDSOL CLINICAL RESEARCH CENTER, INC
Entity Type:Organization
Organization Name:MEDSOL CLINICAL RESEARCH CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:FILOMENA
Authorized Official - Last Name:VASCONCELOS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:941-623-9744
Mailing Address - Street 1:3280 TAMIAMI TRL
Mailing Address - Street 2:SUITE 54 A
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33952-8053
Mailing Address - Country:US
Mailing Address - Phone:941-623-9744
Mailing Address - Fax:941-623-9743
Practice Address - Street 1:3280 TAMIAMI TRL
Practice Address - Street 2:SUITE 54 A
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-8053
Practice Address - Country:US
Practice Address - Phone:941-623-9744
Practice Address - Fax:941-623-9743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-06
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch