MEDICARE: JEWISH COMMUNITY SERVICES OF SOUTH FLORIDA, INC.

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number State
1	251V00000X	Voluntary or Charitable Agency	FL
2	251V00000X	Voluntary or Charitable Agency
3	251S00000X	Community/Behavioral Health Agency

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	97034	OTHER	FL	BCBS OF FL
4	J041478	OTHER	FL	INTEGRATED HEALTH PLAN
5	S5826	OTHER	FL	EMPIRE BCBS
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1831167246
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JEWISH COMMUNITY SERVICES OF SOUTH FLORIDA, INC.

Provider Business Mailing Address
First Line	:	7875 SW 104TH ST STE 101
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33156-2642
Country	:	US
Telephone Number	:	305-899-1587
Fax Number	:	305-899-6367

Provider Business Practice Location Address
First Line	:	12000 BISCAYNE BLVD STE 303
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33181-2720
Country	:	US
Telephone Number	:	305-899-1587
Fax Number	:	305-899-6367

Authorized Official
Title or Position	:	CREDENTIALING MANAGER
Name	:	SIXTO MONTANO
Credential	:
Telephone Number	:	305-403-6513

Provider Enumeration Date	:	03/10/2006
Last Update Date	:	03/02/2026

701 NW 27TH AVE
MIAMI, FL
33125-3012

Practice Phone: 786-744-1900
Practice Fax: 305-760-4141