Organization
AMALIA'S COMMUNITY CLINIC, CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIDICE GISEL CARRILLO CABRERA (ADMINISTRATOR)
(954) 900-2931
Entity
Organization
Contact information
Practice address
5400 S UNIVERSITY DR STE 217, DAVIE, FL 33328-5310
(954) 900-2931
Mailing address
9440 NW 35TH CT, MIAMI, FL 33147-2730
(786) 230-5396
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107149700
—
FL
Enumeration date
02/19/2022
Last updated
02/19/2022
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