NPIMap

Organization Active NPI

Community Health of South Florida, Inc.

  • Federally Qualified Health Center (FQHC)
  • Homestead, FL
National Provider Identifier
1194970228
Registry record updated May 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH OF SOUTH FLORIDA, INC.
Practice address
650 NW 2ND Ave
Homestead, FL 33030-5809
Phone
(305) 247-4221
NPI assigned
Nov 17, 2008
Last updated
May 10, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2013

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

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

650 NW 2ND Ave
Homestead, FL 33030-5809

Mailing address

10300 SW 216TH St
Miami, FL 33190-1003
Phone (305) 253-5100

Other identifiers 2

IdentifierTypeStateIssuer
029572863 - FFSMedicaidFL
029572856 - FQHCMedicaidFL

Other names 1

  • Homestead Middle Other name

Medicare participation

Medicare enrollment files
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 1194970228. Details of each certification follow.

  • CCN 101009 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 101009

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
HOMESTEAD MIDDLE SCHOOL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 25, 2009
Last certification
Mar 25, 2009
Ownership / control type
For profit – corporation
Facility address
650 NW 2ND Avenue
Homestead, FL 33030

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1226880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368144000000",
    "number": "1194970228",
    "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": "650 NW 2ND AVE",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330305809",
            "telephone_number": "305-247-4221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH OF SOUTH FLORIDA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-17",
        "last_updated": "2013-05-10",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029572863 - FFS",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029572856 - FQHC",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Homestead Middle",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Homestead, FL

Sources for this page

Verify at the official NPI Registry.