MEDICARE: CITRUS HEALTH NETWORK-CATS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	323P00000X	Psychiatric Residential Treatment Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235347956
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITRUS HEALTH NETWORK-CATS

Provider Business Mailing Address
First Line	:	4175 W 20TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-5874
Country	:	US
Telephone Number	:
Fax Number	:	305-818-1885

Provider Business Practice Location Address
First Line	:	8400 S PALM DR
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33025-4536
Country	:	US
Telephone Number	:	305-825-0300
Fax Number	:	305-818-1885

Authorized Official
Title or Position	:	CEO
Name	:	MARIO JARDON
Credential	:	LCSW
Telephone Number	:	305-825-0300

Provider Enumeration Date	:	05/18/2007
Last Update Date	:	12/08/2016

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Practice Location Address:

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1154793057 — CITRUS HEALTH NETWORK, INC.
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1215642772 — BRIAN CESPEDES HIS
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1801180450 — DR. JOSE DAVID MORGAN M.D.
Practice Location Address:

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1497528145 — YUSNELY GONZALEZ DE ARMAS
Practice Location Address:

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Directions to “CITRUS HEALTH NETWORK-CATS ” Practice Location

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