Organization
COMMUNITY HEALTH OF SOUTH FLORIDA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRODES H. HARTLEY JR. (CEO)
(305) 253-5100
Entity
Organization
Contact information
Practice address
10300 SW 216TH ST, MIAMI, FL 33190-1003
(305) 253-5100
(305) 252-5881
Mailing address
10300 SW 216TH STREET, MIAMI, FL 33190-1003
(305) 253-5100
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
3928521
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
029572800
—
FL
05
—
029572801
—
FL
05
—
029572804
—
FL
05
—
029572805
—
FL
05
—
029572809
—
FL
05
—
029572810
—
FL
05
—
053715200
—
FL
05
—
060303100
—
FL
01
—
060303101
FLORIDA MEDICAID CASE MANAGEMENT
FL
01
—
060303102
FLORIDA MEDICAID THERAPEUTIC FOSTER CARE
FL
01
—
77026
BCBS
FL
Enumeration date
08/14/2006
Last updated
10/06/2020
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