Provider Demographics
NPI:1962114959
Name:BAPTIST HEALTH COMMUNITY CENTER CORP
Entity type:Organization
Organization Name:BAPTIST HEALTH COMMUNITY CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADRIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:POMPA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-687-9054
Mailing Address - Street 1:815 NW 57TH AVE STE 217
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2041
Mailing Address - Country:US
Mailing Address - Phone:239-687-9054
Mailing Address - Fax:
Practice Address - Street 1:1401 E 4TH AVE STE 203
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-3504
Practice Address - Country:US
Practice Address - Phone:305-646-1227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-21
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)