| Organization Name: | EXTRA MEDICAL CLINIC INC |
| NPI Number: | 1144235094 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MAYRA V PEREZ (OWNER, PRESIDENT) |
| Mailing Address: | 717 Ponce De Leon Blvd Suite 205 Coral Gables |
| State: | FL US |
| Postal Code: | 331342060 |
| Phone Number: | 3054415722 |
| Fax Number: | |
| NPI Enumeration Date: | 07/29/2006 |
| NPI Last Update Date: | 04/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | HCC4063 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |