NPIMap

Organization Active NPI

Banyan Community Health Center, Inc.

  • Case Management Agency
  • Miami, FL
National Provider Identifier
1700559408
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
BANYAN COMMUNITY HEALTH CENTER, INC.
Practice address
1566 SW 1St St
Miami, FL 33135-2103
Phone
(305) 774-3300
NPI assigned
Jul 28, 2021
Last updated
Jul 28, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

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

Authorized official

Name
Vincent Carrodeguas
Title
Ceo
Phone
(305) 398-6100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NU Primary

Addresses

Primary practice location

1566 SW 1St St
Miami, FL 33135-2103

Mailing address

6100 Blue Lagoon Dr Ste 400
Miami, FL 33126-2080
Phone (305) 398-6100

Other identifiers 1

IdentifierTypeStateIssuer
015231603MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Banyan Health Systems18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Locations

1566 SW 1st St
Miami, FL 33135
Phone (305) 642-8325

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627430400000",
    "number": "1700559408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 BLUE LAGOON DR STE 400",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331262080",
            "telephone_number": "305-398-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1566 SW 1ST ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331352103",
            "telephone_number": "305-774-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANYAN COMMUNITY HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-28",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A",
        "authorized_official_last_name": "CARRODEGUAS",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "305-398-6100"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015231603",
            "state": "FL"
        }
    ],
    "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 28, 2021; 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.