| Integrated Community Support, Llc | |
|
13643 Sw 26th St Miami FL 33175-6378 | |
| (305) 400-8281 | |
| (305) 400-8513 |
| Full Name | Integrated Community Support, Llc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 13643 Sw 26th St, Miami, Florida |
| Authorized Official Name and Position | Julio Rodriguez (PRESIDENT) |
| Authorized Official Contact | 7868185289 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrated Community Support, Llc 13643 Sw 26th St Miami FL 33175-6378 Ph: (305) 400-8281 | Integrated Community Support, Llc 13643 Sw 26th St Miami FL 33175-6378 Ph: (305) 400-8281 |
| NPI Number | 1265072078 |
|---|---|
| Provider Enumeration Date | 01/09/2020 |
| Last Update Date | 11/12/2021 |
| Certification Date | 11/12/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265072078 | NPI | - | NPPES |
| 261QM0801X | Medicaid | FL |
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