Active NPI
Citrus Health Network
- Durable Medical Equipment & Medical Supplies
- Hialeah, FL
National Provider Identifier
1669625307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- Legal business name
- CITRUS HEALTH NETWORK
- Practice address
- 4175 W 20TH Ave
Hialeah, FL 33012-5874 - Phone
- (305) 825-0300
- Fax
- (305) 818-1885
- NPI assigned
- Oct 28, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Mario E Jardon, LCSW
- Title
- President,Ceo
- Phone
- (305) 825-0300
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Primary |
Addresses
Primary practice location
4175 W 20TH Ave
Hialeah, FL 33012-5874
Mailing address
4175 W 20TH Ave
Hialeah, FL 33012-5874
Phone (305) 825-0300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 105376101 | Medicaid | FL |
National Provider Directory
National Provider Directory- Tax ID family
- Citrus Health Network Inc
Other organizations with this tax ID 25
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Behavioral Health Agency
- Hialeah, FL
- NPI 1417250002
-
- Community/Retail Pharmacy
- Hialeah, FL
- NPI 1417508573
-
- Community/Behavioral Health Agency
- Hialeah, FL
- NPI 1205598554
-
- Federally Qualified Health Center (FQHC)
- Hialeah, FL
- NPI 1245581917
-
- Federally Qualified Health Center (FQHC)
- Hialeah, FL
- NPI 1275647752
-
- Federally Qualified Health Center (FQHC)
- Hialeah, FL
- NPI 1942506837
-
- Psychiatric Residential Treatment Facility
- Pembroke Pines, FL
- NPI 1235347956
-
- Psychiatric Residential Treatment Facility
- Hialeah, FL
- NPI 1679781397
-
- Community/Retail Pharmacy
- Hialeah, FL
- NPI 1285347450
-
- Occupational Therapist
- Doral, FL
- NPI 1578361390
-
- Behavior Analyst
- Hialeah, FL
- NPI 1881462661
-
- Community/Behavioral Health Agency
- Miami, FL
- NPI 1932559473
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225152000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1225152000000",
"number": "1669625307",
"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": "4175 W 20TH AVE",
"city": "HIALEAH",
"state": "FL",
"postal_code": "330125874",
"telephone_number": "305-825-0300",
"fax_number": "305-818-1885"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CITRUS HEALTH NETWORK",
"organizational_subpart": "NO",
"enumeration_date": "2008-10-28",
"last_updated": "2008-10-28",
"status": "A",
"authorized_official_last_name": "JARDON",
"authorized_official_first_name": "MARIO",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "PRESIDENT,CEO",
"authorized_official_telephone_number": "305-825-0300",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "LCSW"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "105376101",
"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 Oct 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.