BANYAN COMMUNITY HEALTH CENTER INC NPI 1922349737

NPI Information

NPI: 1922349737
Provider Name: BANYAN COMMUNITY HEALTH CENTER, INC
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 10D1010437

Address:
3850 W FLAGLER ST
CORAL GABLES, FL
ZIP 33134
Phone: (305) 774-3400
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BANYAN COMMUNITY HEALTH CENTER, INC is a federally qualified health center (fqhc) clinic center in Coral Gables, FL. BANYAN COMMUNITY HEALTH CENTER, INC NPI is 1922349737. The provider is registered as an organization entity type.

The provider's business location address is:

3850 W FLAGLER ST
CORAL GABLES, FL
ZIP 33134-604
Phone: (305) 774-3400
Fax: (305) 643-7807

The provider's authorized official is Vincent Carrodeguas .
The authorized official title is Ceo and has the following contact phone number (305) 398-6100.

The CLIA number assigned to this NPI record is 10D1010437 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/5/2013 and was last updated on 7/28/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	013881902	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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