MEDICARE: CAN COMMUNITY HEALTH, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207R00000X	Internal Medicine Physician
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
3	1041C0700X	Clinical Social Worker
4	207RI0200X	Infectious Disease Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	21725	OTHER		FL BCBS GROUP #
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043887383
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAN COMMUNITY HEALTH, INC.

Provider Business Mailing Address
First Line	:	PO BOX 1000 DEPT 394
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38148-1926
Country	:	US
Telephone Number	:	941-300-4440
Fax Number	:	941-404-1760

Provider Business Practice Location Address
First Line	:	427 WASHINGTON AVE
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33139-6617
Country	:	US
Telephone Number	:	305-514-0813
Fax Number	:	855-235-4811

Authorized Official
Title or Position	:	PRESIDENT & CEO
Name	:	RISHI B PATEL
Credential	:
Telephone Number	:	941-300-4440

Provider Enumeration Date	:	06/07/2021
Last Update Date	:	01/30/2024

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