Provider Demographics
NPI:1801125992
Name:CLINICARE DIAGNOSTICS, INC.
Entity type:Organization
Organization Name:CLINICARE DIAGNOSTICS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:JOHNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-961-5589
Mailing Address - Street 1:PO BOX 16264
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33766-6264
Mailing Address - Country:US
Mailing Address - Phone:866-961-5589
Mailing Address - Fax:866-961-5586
Practice Address - Street 1:2194 MAIN ST
Practice Address - Street 2:SUITE I
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-5696
Practice Address - Country:US
Practice Address - Phone:866-961-5589
Practice Address - Fax:866-961-5586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-18
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty