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General NPI Number Information
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NPI Number | 1942617642
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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 | 07/15/2014
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Last Update Date | 07/15/2014
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Provider Practice Location Address
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Address Line | 820 SW 1ST ST
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City | HOMESTEAD
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State | FL
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Zip | 33030-6904
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Country | US
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Telephone | 305-248-6037
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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 | CUTLER BAY
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State | FL
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Zip | 33190-1003
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Country | US
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Telephone | 305-252-4827
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Fax | 305-252-5881
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | BRODES H HARTLEY JR.
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Credential |
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Telephone | 305-252-4827
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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