| Ccc Adult Clinic | |
|
1101 Nw 1st St Fort Lauderdale FL 33311-8905 | |
| (954) 467-0880 | |
| (954) 535-2030 |
| Full Name | Ccc Adult Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1101 Nw 1st St, Fort Lauderdale, Florida |
| Authorized Official Name and Position | Alisa Bert (CFO) |
| Authorized Official Contact | 9548474117 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ccc Adult Clinic 1608 Se 3rd Ave Fl 3 Fort Lauderdale FL 33316-2564 Ph: (954) 467-0880 | Ccc Adult Clinic 1101 Nw 1st St Fort Lauderdale FL 33311-8905 Ph: (954) 467-0880 |
| NPI Number | 1134157100 |
|---|---|
| Provider Enumeration Date | 06/29/2006 |
| Last Update Date | 04/29/2026 |
| Certification Date | 04/29/2026 |
| Medicare PECOS PAC ID | 3577472422 |
|---|---|
| Medicare Enrollment ID | O20210623001156 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134157100 | NPI | - | NPPES |
| 253794003 | Medicaid | FL | |
| 00020 | Other | FL | BCBS |
| 372889700 | Medicaid | FL | |
| 113196310 | Medicaid | FL |
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