| Banyan Health Systems, Inc. | |
|
3800 W Flagler St Coral Gables FL 33134-1604 | |
| (305) 774-3400 | |
| (305) 442-0482 |
| Full Name | Banyan Health Systems, Inc. |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 3800 W Flagler St, Coral Gables, Florida |
| Authorized Official Name and Position | Vincent Carrodeguas (CEO) |
| Authorized Official Contact | 3053986100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Banyan Health Systems, Inc. 6100 Blue Lagoon Dr Suite 400 Miami FL 33126-2079 Ph: (305) 398-6100 | Banyan Health Systems, Inc. 3800 W Flagler St Coral Gables FL 33134-1604 Ph: (305) 774-3400 |
| NPI Number | 1205233772 |
|---|---|
| Provider Enumeration Date | 12/01/2014 |
| Last Update Date | 07/28/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205233772 | NPI | - | NPPES |
| 013881903 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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