Organization
SOUTH MEDICAL CENTER GROUP CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSUE ACOSTA (PRESIDENT)
(954) 274-5566
Entity
Organization
Contact information
Practice address
12485 SW 137TH AVE STE 204, MIAMI, FL 33186-4217
(305) 614-1266
Mailing address
12485 SW 137TH AVE STE 204, MIAMI, FL 33186-4217
(305) 614-1266
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
261Q00000X
Clinic/Center
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
03/03/2020
Last updated
05/20/2025
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