Organization
AMALIA'S COMMUNITY CLINIC, CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIDICE GISEL CARRILLO CABRERA (ADMINISTRATOR)
(786) 230-5396
Entity
Organization
Contact information
Practice address
5400 S UNIVERSITY DR STE 217, DAVIE, FL 33328-5310
(954) 900-2931
(954) 909-0174
Mailing address
9440 NW 35TH CT, MIAMI, FL 33147-2730
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/06/2020
Last updated
10/12/2021
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