Organization
BANYAN COMMUNITY HEALTH CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VINCENT CARRODEGUAS (CEO)
(305) 398-6100
Entity
Organization
Contact information
Practice address
3733 W FLAGLER ST, CORAL GABLES, FL 33134-1601
(305) 774-3400
Mailing address
6100 BLUE LAGOON DR STE 400, MIAMI, FL 33126-2080
(305) 398-6100
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013881911
—
FL
Enumeration date
08/19/2021
Last updated
08/19/2021
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