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General NPI Number Information
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NPI Number | 1215732557
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Entity Type | Organization
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Legal Business Name | INFINITY HEALTH COMMUNITY CLINIC
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Dates
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Enumeration Date | 02/19/2025
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 99 NW 183RD ST STE 120
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City | MIAMI GARDENS
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State | FL
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Zip | 33169-4518
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Country | US
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Telephone | 305-490-6797
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Fax | 305-317-5284
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Provider Business Mailing Address
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Address Line | 99 NW 183RD ST STE 120
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City | MIAMI GARDENS
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State | FL
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Zip | 33169-4518
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Country | US
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Telephone | 305-490-6797
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Fax | 305-317-5284
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Authorized Official
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Title or Position | OWNER
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Name | DR. THAMAR MAURICE
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Credential | DNP, ARNP, FNP,PMHNP
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Telephone | 305-490-6797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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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 | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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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 | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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