Provider Demographics
NPI:1639444896
Name:FLORIDA MHS, INC.
Entity Type:Organization
Organization Name:FLORIDA MHS, INC.
Other - Org Name:MAGELLAN COMPLETE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:DIBERNARDI
Authorized Official - Suffix:JR
Authorized Official - Credentials:ESQ
Authorized Official - Phone:410-953-4703
Mailing Address - Street 1:6950 COLUMBIA GATEWAY DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-2706
Mailing Address - Country:US
Mailing Address - Phone:410-953-1000
Mailing Address - Fax:
Practice Address - Street 1:7400 NW 19TH ST
Practice Address - Street 2:SUITE C
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-1242
Practice Address - Country:US
Practice Address - Phone:305-717-5310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MAGELLAN BEHAVIORAL HEALTH, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-03-20
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization