Healthcare Provider Details

I. General information

NPI: 1417527409
Provider Name (Legal Business Name): MIAMI DADE COMMUNITY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2021
Last Update Date: 06/30/2021
Certification Date: 06/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 E HALLANDALE BEACH BLVD STE 306
HALLANDALE BEACH FL
33009-3771
US

IV. Provider business mailing address

1901 SW 1ST ST FL 2
MIAMI FL
33135-1601
US

V. Phone/Fax

Practice location:
  • Phone: 305-631-8931
  • Fax:
Mailing address:
  • Phone: 305-631-8931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JOSE M ROIG
Title or Position: CEO
Credential:
Phone: 305-631-8931