Provider Demographics
NPI:1104006824
Name:GOOD SAMARITAN COMMUNITY HEALTH, INC.
Entity Type:Organization
Organization Name:GOOD SAMARITAN COMMUNITY HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:ROBERTO
Authorized Official - Last Name:NERY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-316-7444
Mailing Address - Street 1:7110 SW 109TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-3968
Mailing Address - Country:US
Mailing Address - Phone:305-661-0171
Mailing Address - Fax:305-468-6349
Practice Address - Street 1:7701 SW 98TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-2634
Practice Address - Country:US
Practice Address - Phone:305-316-7444
Practice Address - Fax:305-468-6349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health