Community Health of South Florida Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

COMMUNITY HEALTH OF SOUTH FLORIDA INC

Practice address

505 SW 8TH St
Homestead, FL 33030-7163

Phone

(305) 242-0973

Fax

(305) 242-4026

NPI assigned

Jul 3, 2008

Last updated

Sep 19, 2013By 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

Brodes H Hartley Jr.

Title

Ceo

Phone

(305) 253-5100

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Laura Saunders Elementary Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1144483652. Details of each certification follow.

• CCN 101952 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 101952

Legal name

COMM HLTH OF S DADE INC LAURA C SAUNDERS ELE SCH

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Jan 8, 2004

Last certification

Jan 8, 2004

Ownership / control type

For profit – partnership

Facility address

505 SW 8TH St
Homestead, FL 33030

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

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379548800000",
    "number": "1144483652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10300 SW 216TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331901003",
            "telephone_number": "305-253-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 SW 8TH ST",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330307163",
            "telephone_number": "305-242-0973",
            "fax_number": "305-242-4026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH OF SOUTH FLORIDA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-03",
        "last_updated": "2013-09-19",
        "status": "A",
        "authorized_official_last_name": "HARTLEY",
        "authorized_official_first_name": "BRODES",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "305-253-5100",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029572816 - FFS",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029572815 - FQHC",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laura Saunders Elementary",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Federally Qualified Health Center (FQHC) in Homestead, FL
• Providers in Homestead, FL by specialty
• Federally Qualified Health Center (FQHC) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.