MEDICARE: BORINQUEN HEALTH CARE CENTER, 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	261QF0400X	Federally Qualified Health Center (FQHC)		FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235458373
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BORINQUEN HEALTH CARE CENTER, INC.

Provider Business Mailing Address
First Line	:	3601 FEDERAL HWY
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33137-3795
Country	:	US
Telephone Number	:	305-576-6611
Fax Number	:	305-576-0008

Provider Business Practice Location Address
First Line	:	11800 NW 2ND ST
Second Line	:	PAUL W BELL MIDDLE SCHOOL
City	:	MIAMI
State	:	FL
Zip	:	33182-1342
Country	:	US
Telephone Number	:	305-576-6611
Fax Number	:

Authorized Official
Title or Position	:	CEO / PRESIDENT
Name	:	PAUL C. VELEZ
Credential	:
Telephone Number	:	305-576-6611

Provider Enumeration Date	:	05/28/2010
Last Update Date	:	09/09/2022

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