NPIMap

Organization Active NPI

Citrus Health Network

  • Community/Behavioral Health Agency
  • Hialeah, FL
National Provider Identifier
1417250002
Registry record updated Dec 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
CITRUS HEALTH NETWORK
Practice address
308 E 9TH St
Hialeah, FL 33010-4216
Phone
(305) 572-7140
Fax
(305) 572-7128
NPI assigned
Dec 21, 2010
Last updated
Dec 21, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2010

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

Authorized official

Name
Mario E. Jardon, LCSW
Title
Ceo & President
Phone
(305) 424-3100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

308 E 9TH St
Hialeah, FL 33010-4216

Mailing address

4175 W 20TH Ave
Hialeah, FL 33012-5874
Phone (305) 424-3100

Other identifiers 1

IdentifierTypeStateIssuer
060304003MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Citrus Health Network Inc26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

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

View all 25

Locations

308 E 9th St
Hialeah, FL 33010
Phone (305) 572-7140

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73826

NPI Registry JSON

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

{
    "created_epoch": "1292889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292889600000",
    "number": "1417250002",
    "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": "305-424-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 E 9TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330104216",
            "telephone_number": "305-572-7140",
            "fax_number": "305-572-7128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITRUS HEALTH NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-21",
        "last_updated": "2010-12-21",
        "status": "A",
        "authorized_official_last_name": "JARDON",
        "authorized_official_first_name": "MARIO",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "CEO & PRESIDENT",
        "authorized_official_telephone_number": "305-424-3100",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060304003",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2010; 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.