NPIMap

Organization Active NPI

Citrus Health Network, Inc

  • Federally Qualified Health Center (FQHC)
  • Miami, FL
National Provider Identifier
1265817639
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CITRUS HEALTH NETWORK, INC
Practice address
8765 SW 165TH Ave Ste 110-114
Miami, FL 33193-5831
Phone
(786) 209-2160
Fax
(786) 209-2161
NPI assigned
Jul 27, 2015
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Mario E Jardon, L.C.S.W,NPI 1407909732
Title
President and C.E.O.
Phone
(305) 424-3100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

8765 SW 165TH Ave Ste 110-114
Miami, FL 33193-5831

Mailing address

4175 W 20TH Ave
Hialeah, FL 33012-5874
Phone (305) 825-0300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040923000283 FL Part B Supplier - Clinic/Group Practice 9931177334 Receives reassigned benefits from 117 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hialeah, FL; Miami, FL

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1437955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1265817639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4175 W 20TH AVE",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330125874",
            "telephone_number": "305-825-0300",
            "fax_number": "305-818-1885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8765 SW 165TH AVE STE 110-114",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331935831",
            "telephone_number": "786-209-2160",
            "fax_number": "786-209-2161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITRUS HEALTH NETWORK, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-27",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "JARDON",
        "authorized_official_first_name": "MARIO",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT AND C.E.O.",
        "authorized_official_telephone_number": "305-424-3100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "L.C.S.W,"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.