Healthcare Provider Details

I. General information

NPI: 1821380080
Provider Name (Legal Business Name): FLORIDA HEALTH CLINIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2011
Last Update Date: 02/20/2024
Certification Date: 02/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5450 SW 8TH ST STE 202
CORAL GABLES FL
33134-2200
US

IV. Provider business mailing address

5450 SW 8TH ST STE 202
CORAL GABLES FL
33134-2200
US

V. Phone/Fax

Practice location:
  • Phone: 305-967-8381
  • Fax: 305-967-8394
Mailing address:
  • Phone: 305-967-8381
  • Fax: 305-967-8394

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License NumberHCC9133
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA58547
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KELLY ACEVEDO
Title or Position: PRESIDENT
Credential: RN
Phone: 786-326-1871