Organization Active NPI

Clinic Center Inc

  • Family Medicine Physician
  • Hialeah, FL
National Provider Identifier
1174555411
Registry record updated Sep 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CLINIC CENTER INC
Practice address
3800 W 12TH Ave
Hialeah, FL 33012-4126
Phone
(305) 557-7777
Fax
(305) 557-6352
NPI assigned
Jul 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Anibal Perez de Gracia
Title
President
Phone
(305) 557-7777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

3800 W 12TH Ave
Hialeah, FL 33012-4126

Mailing address

3800 W 12TH Ave
Hialeah, FL 33012-4126
Phone (305) 557-7777

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2059610Clinic Center Inc3800 W 12TH Ave, Hialeah, FL 33012Certificate of waiverMay 27, 2027

National Provider Directory

National Provider Directory

Locations

3772 W 12th Ave
Hialeah, FL 33012
Phone (305) 557-7777

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379289600000",
    "number": "1174555411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 W 12TH AVE",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330124126",
            "telephone_number": "305-557-7777",
            "fax_number": "305-557-6352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 W 12TH AVE",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330124126",
            "telephone_number": "305-557-7777",
            "fax_number": "305-557-6352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINIC CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2013-09-16",
        "status": "A",
        "authorized_official_last_name": "PEREZ DE GRACIA",
        "authorized_official_first_name": "ANIBAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-557-7777",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.