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General NPI Number Information
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NPI Number | 1780757625
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Entity Type | Organization
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Legal Business Name | COMMUNITY HEALTH OF SOUTH DADE
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 810 W MOWRY DR
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City | HOMESTEAD
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State | FL
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Zip | 33030-5746
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Country | US
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Telephone | 305-242-6040
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Fax | 305-245-1161
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Provider Business Mailing Address
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Address Line | 14139 SW 146TH TER
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City | MIAMI
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State | FL
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Zip | 33186-7206
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Country | US
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Telephone | 305-234-6526
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Fax | 305-245-1161
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | DR. ANTHONY AMOFAH
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Credential | MD
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Telephone | 305-242-6040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | ME84978
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License Number State | FL
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