| Citrus Health Network Inc | |
|
4125 W 20th Ave Hialeah FL 33012-5874 | |
| (305) 424-3100 | |
| (305) 825-1645 |
| Full Name | Citrus Health Network Inc |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 4125 W 20th Ave, Hialeah, Florida |
| Authorized Official Name and Position | Mario E Jardon (CEO) |
| Authorized Official Contact | 3054243100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Citrus Health Network Inc 4175 W 20th Ave Hialeah FL 33012-5874 Ph: (305) 424-3100 | Citrus Health Network Inc 4125 W 20th Ave Hialeah FL 33012-5874 Ph: (305) 424-3100 |
| NPI Number | 1033412184 |
|---|---|
| Provider Enumeration Date | 12/13/2010 |
| Last Update Date | 11/03/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033412184 | NPI | - | NPPES |
| 688571300 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 744441 (Florida) | Primary |
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