Provider Demographics
NPI:1730795311
Name:FLORIDA SOCIAL HEALTH SOLUTIONS LLC
Entity type:Organization
Organization Name:FLORIDA SOCIAL HEALTH SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAZARO
Authorized Official - Middle Name:
Authorized Official - Last Name:MOLINA RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:754-234-4331
Mailing Address - Street 1:6408 N ARMENIA AVE STE E-1
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33604-5770
Mailing Address - Country:US
Mailing Address - Phone:754-234-4331
Mailing Address - Fax:786-687-5207
Practice Address - Street 1:6408 N ARMENIA AVE STE E-1
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33604-5770
Practice Address - Country:US
Practice Address - Phone:754-234-4331
Practice Address - Fax:786-687-5207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-19
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL109807600Medicaid