Healthcare Provider Details

I. General information

NPI: 1831167246
Provider Name (Legal Business Name): JEWISH COMMUNITY SERVICES OF SOUTH FLORIDA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2006
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12000 BISCAYNE BLVD STE 303
NORTH MIAMI FL
33181-2720
US

IV. Provider business mailing address

7875 SW 104TH ST STE 101
MIAMI FL
33156-2642
US

V. Phone/Fax

Practice location:
  • Phone: 305-899-1587
  • Fax: 305-899-6367
Mailing address:
  • Phone: 305-899-1587
  • Fax: 305-899-6367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number StateFL

VIII. Authorized Official

Name: SIXTO MONTANO
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 305-403-6513