Provider Demographics
NPI:1417549080
Name:EVERNORTH DIRECT HEALTH LLC
Entity Type:Organization
Organization Name:EVERNORTH DIRECT HEALTH LLC
Other - Org Name:CITY OF MIAMI EMPLOYEE HEALT
Other - Org Type:Other Name
Authorized Official - Title/Position:FINANCE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:COOLIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-277-1170
Mailing Address - Street 1:444 SW 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-1910
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:444 SW 2ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-1910
Practice Address - Country:US
Practice Address - Phone:623-277-1190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EVERNORTH DIRECT HEALTH LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-05
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center