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)

General Provider Information

NPI Number	:	1386012011
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	:	786-476-2819

Provider Business Practice Location Address
First Line	:	2231 PRAIRIE AVE
Second Line	:	MIAMI BEACH SENIOR HIGH
City	:	MIAMI BEACH
State	:	FL
Zip	:	33139-1517
Country	:	US
Telephone Number	:	305-532-4515
Fax Number	:	305-531-9209

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

Provider Enumeration Date	:	09/11/2015
Last Update Date	:	09/09/2022

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