Organization
COMMUNITY HEALTH OF SOUTH FLORIDA INC
Active
Other names
Martin Luther King & Martin Luther King UCC
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY DAVID RADZIEWICZ (CFO)
(305) 232-6047
Entity
Organization
Contact information
Practice address
810 W MOWRY DR, HOMESTEAD, FL 33030-5746
(305) 248-4334
Mailing address
10300 SW 216TH ST, MIAMI, FL 33190-1003
(305) 253-5100
(305) 254-4987
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
029572801
—
FL
05
—
051423300
—
FL
05
—
060303105
—
FL
Enumeration date
07/03/2008
Last updated
08/29/2024
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