| My Florida Community Health Center Llc | |
|
10887 Nw 17th St Unit 203 Miami FL 33172-2046 | |
| (786) 233-6218 | |
| Not Available |
| Full Name | My Florida Community Health Center Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 10887 Nw 17th St Unit 203, Miami, Florida |
| Authorized Official Name and Position | Lisandra Valdivia (PRESIDENT) |
| Authorized Official Contact | 7862336218 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| My Florida Community Health Center Llc 10887 Nw 17th St Unit 203 Miami FL 33172-2046 Ph: () - | My Florida Community Health Center Llc 10887 Nw 17th St Unit 203 Miami FL 33172-2046 Ph: (786) 233-6218 |
| NPI Number | 1043801970 |
|---|---|
| Provider Enumeration Date | 02/02/2021 |
| Last Update Date | 05/11/2023 |
| Certification Date | 05/11/2023 |
| Medicare PECOS PAC ID | 8426447566 |
|---|---|
| Medicare Enrollment ID | O20211111001480 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043801970 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Eduardo F Bolumen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1174582639 PECOS PAC ID: 3173811239 Enrollment ID: I20161005003075 |
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