Provider Demographics
NPI:1982998597
Name:CLINICA VENAMER LLC
Entity Type:Organization
Organization Name:CLINICA VENAMER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GIANPAOLO
Authorized Official - Middle Name:
Authorized Official - Last Name:BELMONTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-482-9556
Mailing Address - Street 1:10200 NW 25TH ST
Mailing Address - Street 2:UNIT 114
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33172-5921
Mailing Address - Country:US
Mailing Address - Phone:305-482-9556
Mailing Address - Fax:305-482-9557
Practice Address - Street 1:10200 NW 25TH ST
Practice Address - Street 2:UNIT 114
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-5921
Practice Address - Country:US
Practice Address - Phone:305-482-9556
Practice Address - Fax:305-482-9557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-01
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC9551208D00000X
FLHCC9153261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFILE 9659OtherHCC UNIT