Provider Demographics
NPI:1417704198
Name:COMMUNITY HEALTH OF SOUTH FLORIDA, INC
Entity type:Organization
Organization Name:COMMUNITY HEALTH OF SOUTH FLORIDA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:RADZIEWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-232-6047
Mailing Address - Street 1:10300 SW 216TH ST
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33190-1003
Mailing Address - Country:US
Mailing Address - Phone:305-253-5100
Mailing Address - Fax:305-242-2110
Practice Address - Street 1:228 ATLANTIC BLVD
Practice Address - Street 2:
Practice Address - City:KEY LARGO
Practice Address - State:FL
Practice Address - Zip Code:33037-4331
Practice Address - Country:US
Practice Address - Phone:305-253-5100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)