Provider Demographics
NPI:1487684569
Name:AMERICAN FAMILY HEALTH CENTER,INC
Entity Type:Organization
Organization Name:AMERICAN FAMILY HEALTH CENTER,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/ PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FELIX
Authorized Official - Middle Name:ALEJANDRO
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-231-8996
Mailing Address - Street 1:PO BOX 278004
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-8004
Mailing Address - Country:US
Mailing Address - Phone:305-231-8996
Mailing Address - Fax:305-231-8433
Practice Address - Street 1:777 E 25TH ST STE 304
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-3849
Practice Address - Country:US
Practice Address - Phone:305-231-8996
Practice Address - Fax:305-231-8433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME77127207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL262187800Medicaid
FLG08048Medicare UPIN
K5285AMedicare PIN
FLK5285Medicare ID - Type UnspecifiedGROUP #