Organization
CITRUS HEALTH NETWORK INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARIO E JARDON LCSW (CEO)
(305) 424-3100
Entity
Organization
Contact information
Practice address
4125 W 20TH AVE, HIALEAH, FL 33012-5874
(305) 424-3100
(305) 825-1645
Mailing address
4175 W 20TH AVE, HIALEAH, FL 33012-5874
(305) 424-3100
(305) 825-1645
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
744441
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
688571300
—
FL
Enumeration date
12/13/2010
Last updated
11/03/2014
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