Provider Demographics
NPI:1679837280
Name:CHEN NEIGHBORHOOD MEDICAL CENTERS OF SOUTH FLORIDA LLC
Entity Type:Organization
Organization Name:CHEN NEIGHBORHOOD MEDICAL CENTERS OF SOUTH FLORIDA LLC
Other - Org Name:CHEN SENIOR MEDICAL CENTER 95TH STREET
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-628-6117
Mailing Address - Street 1:1000 PARK CENTRE BLVD
Mailing Address - Street 2:#136
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-5373
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2230 NW 95TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33147-2414
Practice Address - Country:US
Practice Address - Phone:305-827-2977
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHEN NEIGHBORHOOD MEDICAL CENTERS OF SOUTH FLORIDA LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-06-28
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No332900000XSuppliersNon-Pharmacy Dispensing SiteGroup - Multi-Specialty