| Ethel F. Beckford / Richmond Elementary | |
|
16929 Sw 104th Ave Miami FL 33157-4239 | |
| (305) 278-5207 | |
| Not Available |
| Full Name | Ethel F. Beckford / Richmond Elementary |
|---|---|
| Speciality | General Practice |
| Location | 16929 Sw 104th Ave, Miami, Florida |
| Authorized Official Name and Position | Jeremy David Radziewicz (CFO) |
| Authorized Official Contact | 3052326047 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ethel F. Beckford / Richmond Elementary 10300 Sw 216th Street Miami FL 33190-1003 Ph: (305) 253-5100 | Ethel F. Beckford / Richmond Elementary 16929 Sw 104th Ave Miami FL 33157-4239 Ph: (305) 278-5207 |
| NPI Number | 1902229313 |
|---|---|
| Provider Enumeration Date | 01/22/2014 |
| Last Update Date | 08/29/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902229313 | NPI | - | NPPES |
| 010762304 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Secondary |
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