Community Health of South Florida, Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · Miami, FL
NPI 1063666899 · NPPES record last updated Sep 19, 2013
Key facts
- NPI
- 1063666899
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- COMMUNITY HEALTH OF SOUTH FLORIDA, INC.
- Practice address
- 6601 SW 152ND Ave
Miami, FL 33193-2152 - Phone
- (305) 382-8760
- NPI assigned
- Nov 6, 2008
- Organization subpart
- No
Authorized official
- Name
- Brodes H Hartley Jr.
- Title
- Ceo
- Phone
- (305) 253-5100
Other NPIs on the same Medicare enrollment 17
Corporate family (same tax ID) 14
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031118000460 | FL | Part B Supplier - Clinic/Group Practice | 6507770526 |
Receives reassigned benefits from 147 practitioners 17 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Tavernier, FL; Cutler Bay, FL; South Miami, FL; Perrine, FL; Naranja, FL; Miami, FL; Marathon, FL; Key West, FL… |
National Provider Directory
- Tax ID family
- Community Health Inc
Locations
6601 SW 152nd Ave
Miami, FL 33193
Phone (305) 382-8760
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
6601 SW 152ND Ave
Miami, FL 33193-2152
Mailing address
10300 SW 216TH St
Miami, FL 33190-1003
Phone (305) 253-5100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 029572848 - FFS | Medicaid | FL | |
| 029572836 - FQHC | Medicaid | FL |
Other names
- Bowman Ashe Doolin K-5
Other providers in Miami, FL
- Community Health of South Florida Inc
- Community Health of South Florida Inc
- Community Health of South Florida Inc
- Community Health of South Florida, Inc.
- Community Health of South Florida, Inc.
- Community Health of South Florida, Inc.
- Community Health of South Florida, Inc.
- Community Health of South Florida, Inc.
- Community Health of South Florida, Inc.
- Community Health of South Florida, Inc.
All providers in Miami, FL · Federally Qualified Health Center (FQHC) in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 19, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.