NPIMap

Organization Active NPI

Coral CMHC Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Miami, FL
National Provider Identifier
1396820247
Registry record updated May 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
CORAL CMHC INC
Practice address
2141 SW 1St St
Suite 103
Miami, FL 33135-1694
Phone
(305) 644-6024
NPI assigned
Oct 26, 2006
Last updated
May 16, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2020

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

Authorized official

Name
Mr. Carlos A. Cordova, LMHCNPI 1164626693
Title
President
Phone
(305) 644-6024

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

2141 SW 1St St
Suite 103
Miami, FL 33135-1694

Mailing address

2141 SW 1St St
Suite 103
Miami, FL 33135-1694
Phone (305) 644-6024

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20061113000092 FL Part A Provider - Community Mental Health Center 4082612775 Practice locations: Miami, FL
O20200113001647 FL Part B Supplier - Clinic/Group Practice 4082612775 Receives reassigned benefits from 9 practitioners
Practice locations: Miami, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1396820247. Details of each certification follow.

  • CCN 104768 Community mental health center · Active · Name & address match · Details

Community mental health center certification: CCN 104768

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
CORAL CMHC
Certification status
Active
Provider type (POS)
Community mental health center
Participating since
Aug 1, 2007
Last certification
Jan 24, 2024
Ownership / control type
For profit – individual
Facility address
2141 SW 1St Street, Suite 103
Miami, FL 33135

National Provider Directory

National Provider Directory

Locations

2141 SW 1st St
Ste 103
Miami, FL 33135
Phone (305) 644-6024

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 78

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 78

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589587200000",
    "number": "1396820247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2141 SW 1ST ST",
            "address_2": "SUITE 103",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331351694",
            "telephone_number": "305-644-6024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2141 SW 1ST ST",
            "address_2": "SUITE 103",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331351694",
            "telephone_number": "305-644-6024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORAL CMHC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2020-05-16",
        "certification_date": "2020-05-16",
        "status": "A",
        "authorized_official_last_name": "CORDOVA",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-644-6024",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.