NPIMap

Organization Active NPI

South Florida Community Care Network, LLC

  • Health Maintenance Organization
  • Sunrise, FL
National Provider Identifier
1124845300
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
Legal business name
SOUTH FLORIDA COMMUNITY CARE NETWORK, LLC
Practice address
1643 Harrison Pkwy Ste H-200
Sunrise, FL 33323-3091
Phone
(954) 622-3237
NPI assigned
Sep 20, 2024
Organization subpart
Yes
Parent organization
SOUTH FLORIDA COMMUNITY CARE NETWORK, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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

Authorized official

Name
Ms. Lupe Rivero
Title
SVP & Chief Business Dev. Officer
Phone
(954) 622-3237

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X Primary

Addresses

Primary practice location

1643 Harrison Pkwy Ste H-200
Sunrise, FL 33323-3091

Mailing address

1643 Harrison Pkwy Ste H-200
Sunrise, FL 33323-3091
Phone (954) 622-3237

Other identifiers 1

IdentifierTypeStateIssuer
1232282-07MedicaidFL

Other names 2

  • Community Care Plan Doing business as
  • CCP MMA-Region E Other name

National Provider Directory

National Provider Directory
Tax ID family
South Florida Community Care Network LLC11 organizations share this tax ID, including this one
Part of
South Florida Community Care Network LLC

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1643 NW 136th Ave
Ste 200
Sunrise, FL 33323

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1726790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726790400000",
    "number": "1124845300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1643 HARRISON PKWY STE H-200",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333233091",
            "telephone_number": "954-622-3237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1643 HARRISON PKWY STE H-200",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333233091",
            "telephone_number": "954-622-3237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH FLORIDA COMMUNITY CARE NETWORK, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTH FLORIDA COMMUNITY CARE NETWORK, LLC",
        "enumeration_date": "2024-09-20",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A",
        "authorized_official_last_name": "RIVERO",
        "authorized_official_first_name": "LUPE",
        "authorized_official_title_or_position": "SVP & CHIEF BUSINESS DEV. OFFICER",
        "authorized_official_telephone_number": "954-622-3237",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1232282-07",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Care Plan",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CCP MMA-Region E",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Sunrise, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.