Organization
MIRACLE COMMUNITY BEHAVIORAL CENTER CORP
Active
Other names
MIRACLE MEDICAL CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
BRISAIDA DUARTE (CEO)
(786) 697-1150
Entity
Organization
Contact information
Practice address
15660 SW 72ND ST, MIAMI, FL 33193-1923
(786) 697-1150
Mailing address
15660 SW 72ND ST, MIAMI, FL 33193-1923
(786) 697-1150
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
225100000X
Physical Therapist
—
—
225200000X
Physical Therapy Assistant
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118354400
—
FL
01
—
15527884
CAQH
FL
01
—
42711
HEALTH CARE CLINIC CERTIFICATE (AHCA)
FL
Enumeration date
09/09/2020
Last updated
08/25/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us