| Royal Green Elementary | |
|
13047 Sw 47th St Miami FL 33175-4517 | |
| (305) 221-4452 | |
| Not Available |
| Full Name | Royal Green Elementary |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 13047 Sw 47th St, Miami, Florida |
| Authorized Official Name and Position | Brodes H Hartley (CEO) |
| Authorized Official Contact | 3052535100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Royal Green Elementary 10300 Sw 216th St Miami FL 33190-1003 Ph: (305) 253-5100 | Royal Green Elementary 13047 Sw 47th St Miami FL 33175-4517 Ph: (305) 221-4452 |
| NPI Number | 1538313861 |
|---|---|
| Provider Enumeration Date | 11/13/2008 |
| Last Update Date | 09/19/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538313861 | NPI | - | NPPES |
| 029572869 - FFS | Medicaid | FL | |
| 029572868 - FQHC | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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