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General NPI Number Information
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NPI Number | 1033155643
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Entity Type | Organization
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Legal Business Name | BANYAN COMMUNITY HEALTH CENTER, INC.
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Dates
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Enumeration Date | 06/21/2006
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 3850 W FLAGLER ST
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City | CORAL GABLES
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State | FL
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Zip | 33134-1604
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Country | US
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Telephone | 305-442-1732
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Fax | 305-442-7175
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Provider Business Mailing Address
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Address Line | 2300 NW 89TH PL FL 3
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City | DORAL
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State | FL
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Zip | 33172-2431
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Country | US
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Telephone | 305-398-6100
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MANUEL ANDRES FERNANDEZ
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Credential |
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Telephone | 561-213-9211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH9579
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License Number State | FL
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