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General NPI Number Information
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NPI Number | 1659183598
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Entity Type | Organization
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Legal Business Name | HERAS COMMUNITY HEALTH CARE
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Dates
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Enumeration Date | 01/27/2025
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Last Update Date | 08/31/2025
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Provider Practice Location Address
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Address Line | 5400 S UNIVERSITY DR STE 118
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City | DAVIE
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State | FL
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Zip | 33328-5309
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Country | US
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Telephone | 954-526-1540
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Fax | 954-827-0205
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Provider Business Mailing Address
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Address Line | 5400 S UNIVERSITY DR STE 118
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City | DAVIE
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State | FL
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Zip | 33328-5309
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Country | US
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Telephone | 954-526-1540
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Fax | 954-827-0205
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Authorized Official
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Title or Position | PRESIDENT
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Name | JUAN ANTONIO RODRIGUEZ
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Credential |
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Telephone | 305-956-8107
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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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 | 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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