Provider Demographics
NPI:1487729653
Name:COMMUNITY HEALTH OF SOUTH DADE INC
Entity type:Organization
Organization Name:COMMUNITY HEALTH OF SOUTH DADE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COORDINATOR CHILDREN'S SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:LOLA
Authorized Official - Middle Name:MAY
Authorized Official - Last Name:TAYLOR-JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:305-252-4886
Mailing Address - Street 1:10300 SW 216TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33190-1003
Mailing Address - Country:US
Mailing Address - Phone:305-252-4886
Mailing Address - Fax:305-238-7617
Practice Address - Street 1:10300 SW 216TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33190-1003
Practice Address - Country:US
Practice Address - Phone:305-252-4886
Practice Address - Fax:305-238-7617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization