# AMALIA'S COMMUNITY CLINIC, CORP

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255966511
- **Authorized official:** LIDICE GISEL CARRILLO CABRERA (ADMINISTRATOR)
- **Authorized official phone:** (786) 230-5396

## Contact information

- **Practice address:** 5400 S UNIVERSITY DR STE 217, DAVIE, FL 33328-5310
- **Practice address phone:** (954) 900-2931
- **Practice address fax:** (954) 909-0174
- **Mailing address:** 9440 NW 35TH CT, MIAMI, FL 33147-2730

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/06/2020
- **Last updated:** 10/12/2021