Organization
EXTRA MEDICAL CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MAYRA V PEREZ (OWNER, PRESIDENT)
(305) 441-5722
Entity
Organization
Contact information
Practice address
717 PONCE DE LEON BLVD, SUITE 205, CORAL GABLES, FL 33134-2060
(305) 441-5722
Mailing address
717 PONCE DE LEON BLVD, SUITE 205, CORAL GABLES, FL 33134-2060
(305) 441-5722
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
HCC4063
FL
Other
Enumeration date
07/29/2006
Last updated
08/22/2020
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