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General NPI Number Information
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NPI Number | 1053780734
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Entity Type | Organization
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Legal Business Name | MIAMI BEACH COMMUNITY HEALTH CENTER INC
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Dates
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Enumeration Date | 09/23/2015
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Last Update Date | 10/29/2025
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Provider Practice Location Address
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Address Line | 11645 BISCAYNE BLVD SUITE 401, 403, 405
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City | MIAMI
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State | FL
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Zip | 33181-3139
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Country | US
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Telephone | 305-538-8835
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Fax | 305-994-0054
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Provider Business Mailing Address
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Address Line | 11645 BISCAYNE BLVD STE 207
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City | MIAMI
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State | FL
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Zip | 33181-3138
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Country | US
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Telephone | 305-538-8835
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Fax | 305-994-0054
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Authorized Official
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Title or Position | CHIEF HUMAN RESOURCE OFFICER
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Name | LIZEL V GONZALEZ
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Credential | ESQ
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Telephone | 305-538-8835
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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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 | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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