Healthcare Provider Details

I. General information

NPI: 1114585643
Provider Name (Legal Business Name): SUNSOUTH HEALTH CENTERS SOUTH FLORIDA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2019
Last Update Date: 05/05/2021
Certification Date: 05/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 NW 17TH AVE
MIAMI FL
33125-1513
US

IV. Provider business mailing address

14255 SW 42ND ST
MIAMI FL
33175-6408
US

V. Phone/Fax

Practice location:
  • Phone: 305-925-0009
  • Fax: 305-697-0009
Mailing address:
  • Phone: 305-306-3400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: CARLOS ARIAS
Title or Position: CEO
Credential:
Phone: 407-558-1872