Community Life Support,Inc

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

COMMUNITY LIFE SUPPORT,INC

Practice address

486 Fisherman St
Opa Locka, FL 33054-3818

Phone

(305) 688-5456

Fax

(305) 688-1661

NPI assigned

Dec 5, 2024

Last updated

Dec 5, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Yadira I Munoz

Title

Manager

Phone

(305) 505-7518

Specialties & licenses 1

Addresses

Other names 1

• COMMUNITY LIFE SUPPORT,INC Former legal business name

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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.

• Pierre R Blemur, MD

  • General Practice Physician
  • Opa Locka, FL
  • NPI 1730177098
  NPD

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

{
    "created_epoch": "1733356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733356800000",
    "number": "1093521908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "486 FISHERMAN ST",
            "city": "OPA LOCKA",
            "state": "FL",
            "postal_code": "330543818",
            "telephone_number": "305-688-5456",
            "fax_number": "305-688-1661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "486 FISHERMAN ST",
            "city": "OPA LOCKA",
            "state": "FL",
            "postal_code": "330543818",
            "telephone_number": "305-688-5456",
            "fax_number": "305-688-1661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY LIFE SUPPORT,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-05",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A",
        "authorized_official_last_name": "MUNOZ",
        "authorized_official_first_name": "YADIRA",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "305-505-7518"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COMMUNITY LIFE SUPPORT,INC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Tiffany L Cobb
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• Marisbel Cordova

• Clinic/Center in Opa Locka, FL
• Providers in Opa Locka, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; 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.