=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013895465
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SOUTH FLORIDA COMMUNITY HEALTH CENTERS, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/25/2025
-----------------------------------------------------
Last Update Date | 08/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9050 PINES BLVD STE 110
-----------------------------------------------------
City | PEMBROKE PINES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33024-6461
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-237-3000
-----------------------------------------------------
Fax | 954-837-9299
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9050 PINES BLVD STE 110
-----------------------------------------------------
City | PEMBROKE PINES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33024-6461
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-603-1000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGE CARE DIRECTORY
-----------------------------------------------------
Name | JORGE A GARCIA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 305-606-0337
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261Q00000X
-----------------------------------------------------
Taxonomy Name | Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------