Provider Demographics
NPI:1558409540
Name:COMMUNITY HEALTH OF SOUTH FLORIDA INC
Entity Type:Organization
Organization Name:COMMUNITY HEALTH OF SOUTH FLORIDA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OFFICER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRODES
Authorized Official - Middle Name:H
Authorized Official - Last Name:HARTLEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:305-252-4853
Mailing Address - Street 1:10300 SW 216TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33190-1003
Mailing Address - Country:US
Mailing Address - Phone:305-253-5100
Mailing Address - Fax:305-254-2011
Practice Address - Street 1:10300 SW 216TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33190-1003
Practice Address - Country:US
Practice Address - Phone:305-253-5100
Practice Address - Fax:305-254-2011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH6037261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health