Amalia'S Community Clinic, Corp

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

AMALIA'S COMMUNITY CLINIC, CORP

Practice address

5400 S University Dr Ste 217
Davie, FL 33328-5310

Phone

(954) 900-2931

Fax

(954) 909-0174

NPI assigned

Mar 6, 2020

Organization subpart

No

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

Authorized official

Name

Lidice Gisel Carrillo Cabrera

Title

Administrator

Phone

(786) 230-5396

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1583452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633996800000",
    "number": "1255966511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9440 NW 35TH CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331472730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 S UNIVERSITY DR STE 217",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333285310",
            "telephone_number": "954-900-2931",
            "fax_number": "954-909-0174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMALIA'S COMMUNITY CLINIC, CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-06",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A",
        "authorized_official_last_name": "CARRILLO CABRERA",
        "authorized_official_first_name": "LIDICE",
        "authorized_official_middle_name": "GISEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "786-230-5396"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Amazing Kiddos World Behavioral Services Corp

• Family Medicine Physician in Davie, FL
• Providers in Davie, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.