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General NPI Number Information
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NPI Number | 1821251331
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Entity Type | Organization
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Legal Business Name | COMMUNITY HEALTH OF SOUTH FLORIDA INC
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Dates
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Enumeration Date | 07/03/2008
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Last Update Date | 08/29/2024
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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 | 305-248-4334
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Fax |
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Provider Business Mailing Address
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Address Line | 10300 SW 216TH ST
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City | MIAMI
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State | FL
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Zip | 33190-1003
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Country | US
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Telephone | 305-253-5100
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Fax | 305-254-4987
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Authorized Official
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Title or Position | CFO
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Name | JEREMY DAVID RADZIEWICZ
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Credential |
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Telephone | 305-232-6047
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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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 | 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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