| NPI | 1053548537 |
|---|---|
| Doing Business As | LICE CLEANIQUE |
| Former Legal Business Name | LICE CLEANIQUE, LLC. |
| Doing Business As | SOUTH FLORIDA FAMILY HEALTH & RESEARCH CENTERS |
| Entity Type | Organization |
| Authorized Contact | TIMOTHY RIVERA Authorized Official 305-387-0081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL HCC8585) |
| Additional Taxonomies | 261Q00000X (Licence: FL HCC8585) |
| 261QH0100X Clinic/Center, Health Services (Licence: FL HCC8585) | |
| 261QM1300X Clinic/Center, Multi-Specialty (Licence: FL HCC8585) | |
| 261QR1100X Clinic/Center, Research (Licence: FL HCC8585) | |
| 261QS1000X Clinic/Center, Student Health (Licence: FL HCC8585) | |
| Enumeration Date | 2009-06-11 |
| Last Update Date | 2018-10-05 |