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NPI Code Detail

MEDICARE: TESALIA COMMUNITY CENTER INC

MEDICARE: TESALIA COMMUNITY 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
1103K00000XBehavior Analyst
2251B00000XCase Management Agency
3251E00000XHome Health Agency
4291U00000XClinical Medical Laboratory
5251S00000XCommunity/Behavioral Health Agency

Other Identifiers

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

General Provider Information

NPI Number : 1952998585
Entity Type Code : Organization
Provider Name (Legal Business Name) : TESALIA COMMUNITY CENTER INC
Provider Business Mailing Address
First Line : 2141 SW 1ST ST STE 201
Second Line :
City : MIAMI
State : FL
Zip : 33135-5602
Country : US
Telephone Number : 786-973-0957
Fax Number :
Provider Business Practice Location Address
First Line : 2141 SW 1ST ST STE 201
Second Line :
City : MIAMI
State : FL
Zip : 33135-5602
Country : US
Telephone Number : 786-973-0957
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DORAIMIS RODRIGUEZ
Credential :
Telephone Number : 786-310-7678
Provider Enumeration Date : 12/29/2020
Last Update Date : 08/05/2025

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Directions to “TESALIA COMMUNITY CENTER INC ” Practice Location

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