Organization
CALIFORNIA CLUB DIAGNOSTICS CENTER, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXANDER BARONOV (PRESIDENT)
(305) 405-0365
Entity
Organization
Contact information
Practice address
850 IVES DAIRY RD UNIT 14, NORTH MIAMI BEACH, FL 33179-2450
(305) 405-0365
(305) 405-0370
Mailing address
850 IVES DAIRY RD UNIT 14, NORTH MIAMI BEACH, FL 33179-2450
(305) 405-0365
(305) 405-0370
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
08/30/2006
Last updated
08/22/2020
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