NPIMap

Organization Active NPI

Community Health of South Florida, Inc.

  • General Practice Physician
  • Miami, FL
National Provider Identifier
1902229313
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
COMMUNITY HEALTH OF SOUTH FLORIDA, INC.
Practice address
16929 SW 104TH Ave
Miami, FL 33157-4239
Phone
(305) 278-5207
NPI assigned
Jan 22, 2014
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Jeremy David Radziewicz
Title
Cfo
Phone
(305) 232-6047

Corporate family (same tax ID) 21

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

National Provider Directory

National Provider Directory
Tax ID family
Community Health Inc (57 organizations share this tax ID)

Locations

16929 SW 104th Ave
Miami, FL 33157
Phone (305) 278-5207

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary
Federally Qualified Health Center (FQHC) 261QF0400X

Addresses

NPPES NPI Registry

Primary practice location

16929 SW 104TH Ave
Miami, FL 33157-4239

Mailing address

10300 SW 216TH Street
Miami, FL 33190-1003
Phone (305) 253-5100

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
010762304MedicaidFL

Other names 1

NPPES NPI Registry
  • Ethel F. Beckford / Richmond Elementary Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 29, 2024.

{
    "created_epoch": "1390348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724889600000",
    "number": "1902229313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10300 SW 216TH STREET",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331901003",
            "telephone_number": "305-253-5100",
            "fax_number": "305-254-4987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16929 SW 104TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331574239",
            "telephone_number": "305-278-5207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH OF SOUTH FLORIDA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-22",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A",
        "authorized_official_last_name": "RADZIEWICZ",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "305-232-6047"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010762304",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ethel F. Beckford / Richmond Elementary",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Aug 29, 2024; 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.