| Citrus Health Network, Inc | |
|
8765 Sw 165th Ave Ste 110-114 Miami FL 33193-5831 | |
| (786) 209-2160 | |
| (786) 209-2161 |
| Full Name | Citrus Health Network, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 8765 Sw 165th Ave Ste 110-114, Miami, Florida |
| Authorized Official Name and Position | Mario E Jardon (PRESIDENT AND C.E.O.) |
| Authorized Official Contact | 3054243100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Citrus Health Network, Inc 4175 W 20th Ave Hialeah FL 33012-5874 Ph: (305) 825-0300 | Citrus Health Network, Inc 8765 Sw 165th Ave Ste 110-114 Miami FL 33193-5831 Ph: (786) 209-2160 |
| NPI Number | 1265817639 |
|---|---|
| Provider Enumeration Date | 07/27/2015 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 9931177334 |
|---|---|
| Medicare Enrollment ID | O20171017001405 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265817639 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Florida) | Primary |
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