MEDICARE: CARE RESOURCE COMMUNITY HEALTH CENTERS, INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency		FL
2	261QF0400X	Federally Qualified Health Center (FQHC)		FL

General Provider Information

NPI Number	:	1093717464
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARE RESOURCE COMMUNITY HEALTH CENTERS, INC

Provider Business Mailing Address
First Line	:	3510 BISCAYNE BLVD
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33137-3859
Country	:	US
Telephone Number	:	305-576-1234
Fax Number	:	305-571-2020

Provider Business Practice Location Address
First Line	:	871 W OAKLAND PARK BLVD
Second Line	:
City	:	WILTON MANORS
State	:	FL
Zip	:	33311
Country	:	US
Telephone Number	:	954-567-7141
Fax Number	:	954-565-5624

Authorized Official
Title or Position	:	CEO
Name	:	DR. STEVEN SANTIAGO
Credential	:	MD
Telephone Number	:	305-576-1234

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	01/24/2025

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