Organization Active NPI

Bolanos Clinical Research LLC

  • Research Clinic/Center
  • Pembroke Pines, FL
National Provider Identifier
1699627083
Registry record updated Feb 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Research Clinic/CenterTaxonomy code 261QR1100X
Legal business name
BOLANOS CLINICAL RESEARCH LLC
Practice address
12105 Taft St
Pembroke Pines, FL 33026-1957
Phone
(754) 232-1114
Fax
(954) 416-6283
NPI assigned
Feb 10, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2026

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

Authorized official

Name
Mr. Alain Alvarez Legra
Title
Manager
Phone
(754) 232-1114

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Research Clinic/Center 261QR1100X Primary

Addresses

Primary practice location

12105 Taft St
Pembroke Pines, FL 33026-1957

Mailing address

12105 Taft St
Pembroke Pines, FL 33026-1957
Phone (754) 232-1114

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
10D2308644Bolanos Clinical Research12105 Taft St, Pembroke Pines, FL 33026Certificate of waiverJul 30, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1770681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770681600000",
    "number": "1699627083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12105 TAFT ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330261957",
            "telephone_number": "754-232-1114",
            "fax_number": "954-416-6283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12105 TAFT ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330261957",
            "telephone_number": "754-232-1114",
            "fax_number": "954-416-6283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOLANOS CLINICAL RESEARCH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-10",
        "last_updated": "2026-02-10",
        "certification_date": "2026-01-24",
        "status": "A",
        "authorized_official_last_name": "ALVAREZ LEGRA",
        "authorized_official_first_name": "ALAIN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "754-232-1114",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Research",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2026; 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.