# POLICLINICO SANTA CLARA INC

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

## Provider details

- **NPI number:** 1811965395
- **Authorized official:** HENRY LORA MD (OWNER)
- **Authorized official phone:** (305) 631-9903

## Contact information

- **Practice address:** 2742 SW 8TH ST, SUITE 19, MIAMI, FL 33135-4650
- **Practice address phone:** (305) 631-9903
- **Practice address fax:** (305) 649-6364
- **Mailing address:** 2742 SW 8TH ST, SUITE 19, MIAMI, FL 33135-4650
- **Mailing address phone:** (305) 631-9903
- **Mailing address fax:** (305) 649-6364

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/09/2006
- **Last updated:** 09/22/2008