Clinica Medica Doctor Vizcarra

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

68630 Issued in GA

Legal business name

CLINICA MEDICA DOCTOR VIZCARRA

Practice address

6825 Jimmy Carter Blvd
Suite 1590
Norcross, GA 30071-1228

Phone

(678) 615-2565

NPI assigned

Oct 1, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Luis Rafael Vizcarra-Falla, M.D.

Title

Medical Director

Phone

(678) 615-2565

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1380585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380585600000",
    "number": "1629405964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6825 JIMMY CARTER BLVD",
            "address_2": "SUITE 1590",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300711228",
            "telephone_number": "678-615-2565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6825 JIMMY CARTER BLVD",
            "address_2": "SUITE 1590",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300711228",
            "telephone_number": "678-615-2565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA MEDICA DOCTOR VIZCARRA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-01",
        "last_updated": "2013-10-01",
        "status": "A",
        "authorized_official_last_name": "VIZCARRA-FALLA",
        "authorized_official_first_name": "LUIS",
        "authorized_official_middle_name": "RAFAEL",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "678-615-2565",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "GA",
            "license": "68630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Latesha Evette Cleary
• Edmund Robert Clement, M.D.
• Amanda Clements
• Heather Lee Clemons, M.D.
• Clinic for Education, Treatment and Prevention of Addiction, Inc.
• Clinica Nueva LLC
• Clinica Union
• Cnu Medical Institute
• Cnu Medical Institute
• Cnu Medical LLC

• Primary Care Clinic/Center in Norcross, GA
• Providers in Norcross, GA by specialty
• Primary Care Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.