Healthcare Provider Details

I. General information

NPI: 1679005300
Provider Name (Legal Business Name): CURLEY'S HOUSE COMMUNITY HEALTH NETWORK, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2017
Last Update Date: 03/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 S FEDERAL HWY 300
HOLLYWOOD FL
33020-6811
US

IV. Provider business mailing address

6025 NW 6TH CT
MIAMI FL
33127-1146
US

V. Phone/Fax

Practice location:
  • Phone: 786-720-0699
  • Fax:
Mailing address:
  • Phone: 786-262-2851
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number StateFL

VIII. Authorized Official

Name: MR. BARRY WARNER SMITH
Title or Position: PRESIDENT
Credential:
Phone: 786-720-0699