Healthcare Provider Details
I. General information
NPI: 1255752853
Provider Name (Legal Business Name): MIAMI BEACH COMMUNITY HEALTH CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/27/2013
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11645 BISCAYNE BLVD STE 309
MIAMI FL
33181-3139
US
IV. Provider business mailing address
11645 BISCAYNE BLVD STE 207
MIAMI FL
33181-3138
US
V. Phone/Fax
- Phone: 305-538-8835
- Fax: 305-994-0054
- Phone: 305-538-8835
- Fax: 305-938-4044
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QF0400X |
| Taxonomy | Federally 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