NPIMap

Organization Active NPI

Florida Department of Health

  • Public Health or Welfare Agency
  • Doral, FL
National Provider Identifier
1720171895
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
FLORIDA DEPARTMENT OF HEALTH
Practice address
8175 NW 12TH Street
Suite 306
Doral, FL 33126-1828
Phone
(786) 845-0164
Fax
(305) 470-5846
NPI assigned
Oct 2, 2006
Organization subpart
Yes
Parent organization
FLORIDA DEPARTMENT OF HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

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

Authorized official

Name
Patricia Bustamante
Title
Revenue Administrator I - Ses
Phone
(786) 845-0164

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X Primary

Addresses

Primary practice location

8175 NW 12TH Street
Suite 306
Doral, FL 33126-1828

Mailing address

8175 NW 12TH St
Micc BLDG Suite 306
Doral, FL 33126-1828
Phone (786) 845-0164

Other practice location 1

971 NW 2nd St
Miami, FL 33128-1205
Phone (305) 575-3800

Other practice location 2

1350 NW 14th St
Miami, FL 33125-1609
Phone (305) 575-3800

Other identifiers 1

IdentifierTypeStateIssuer
027923400MedicaidFL

Other names 1

  • Miami Dade County Health Department Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040525000679 FL Part B Supplier - Clinic/Group Practice 3072424282 Receives reassigned benefits from 17 practitioners
Practice locations: Florida City, FL; Miami, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0024196Florida Department of Health in Miami Dade County1350 NW 14TH Street, Miami, FL 33125ComplianceDec 28, 2027

National Provider Directory

National Provider Directory
Part of
Dept of Health Central Pharmacy

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Walton Community Health CenterDefuniak Springs, FL, CCN 101136 Federally qualified health center Operational/Managerial Control (100%) Sep 7, 2010
Bradford Community Health Care IncStarke, FL, CCN 101182 Federally qualified health center Operational/Managerial Control (100%) Oct 1, 2013

Practitioners & affiliated clinicians

Practitioners 191

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 191

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780272000000",
    "number": "1720171895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8175 NW 12TH ST",
            "address_2": "MICC BLDG SUITE 306",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331261828",
            "telephone_number": "786-845-0164",
            "fax_number": "305-470-5846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8175 NW 12TH STREET",
            "address_2": "SUITE 306",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331261828",
            "telephone_number": "786-845-0164",
            "fax_number": "305-470-5846"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "971 NW 2nd St",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331281205",
            "country_code": "US",
            "telephone_number": "305-575-3800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1350 NW 14th St",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331251609",
            "country_code": "US",
            "telephone_number": "305-575-3800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FLORIDA DEPARTMENT OF HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FLORIDA DEPARTMENT OF HEALTH",
        "enumeration_date": "2006-10-02",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A",
        "authorized_official_last_name": "BUSTAMANTE",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "REVENUE ADMINISTRATOR I - SES",
        "authorized_official_telephone_number": "786-845-0164"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "027923400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Miami Dade County Health Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Doral, FL

Sources for this page

Verify at the official NPI Registry.