Healthcare Provider Details

I. General information

NPI: 1215732557
Provider Name (Legal Business Name): INFINITY HEALTH COMMUNITY CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2025
Last Update Date: 02/19/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 NW 183RD ST STE 120
MIAMI GARDENS FL
33169-4518
US

IV. Provider business mailing address

99 NW 183RD ST STE 120
MIAMI GARDENS FL
33169-4518
US

V. Phone/Fax

Practice location:
  • Phone: 305-490-6797
  • Fax: 305-317-5284
Mailing address:
  • Phone: 305-490-6797
  • Fax: 305-317-5284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. THAMAR MAURICE
Title or Position: OWNER
Credential: DNP, ARNP, FNP,PMHNP
Phone: 305-490-6797