MY CLINIC INTEGRAL MEDICAL CENTER INC
Managed Care Organizations at 137 Ave, Miami, FL

License number
Florida MA62083
Category
Managed Care Organizations
Type
Point of Service
Owner
Name: YUSDEIVYS PEREZ MA62083
Title: OWNER
Phone: (786) 378-0649
Address
Address
2711 SW 137Th Ave #93, Miami, FL 33175
National Provider ID: 1396180535
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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MY CLINIC INTEGRAL MEDICAL CENTER INC

Miami, FL

Status:
Inactive
Industry:
Medical Doctor's Office
Inactive reason:
AMENDMENT
Registration:
Apr 17, 2013
Inactive since:
Jun 4, 2013
Phone:
(305) 646-1932 (Phone)
Addresses:
11880 SW 19 Ter 121, Miami, FL 33175 (Physical)
2711 SW 137 Ave, Miami, FL 33175
11880 SW 19 Ter, Miami, FL 33175
State ID:
P13000034596
Business type:
Florida Profit Corporation
Vice Presidents:
Perez, Yusdeivys, 11880 SW 19 Ter #121, Miami, FL 33175 (Physical),Yusdeivys Perez (President),Danny Jacomino Secretary, inactive,...
EIN:
46-2552773

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