Healthcare Provider Details

I. General information

NPI: 1104357565
Provider Name (Legal Business Name): MIAMI BEACH COMMUNITY HEALTH CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2017
Last Update Date: 12/23/2024
Certification Date: 12/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11645 BISCAYNE BLVD STE 302&304
MIAMI FL
33181-3155
US

IV. Provider business mailing address

11645 BISCAYNE BLVD STE 207
NORTH MIAMI FL
33181-3138
US

V. Phone/Fax

Practice location:
  • Phone: 305-538-8835
  • Fax: 305-994-0054
Mailing address:
  • Phone: 305-538-8835
  • Fax: 305-938-4044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MARK RABINOWITZ
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: MD
Phone: 305-538-8835