Provider Demographics
NPI:1801361902
Name:NEW FLORIDA COMMUNITY SERVICES, INC.
Entity Type:Organization
Organization Name:NEW FLORIDA COMMUNITY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARELVI
Authorized Official - Middle Name:J
Authorized Official - Last Name:AGUERO
Authorized Official - Suffix:
Authorized Official - Credentials:CBHCMS
Authorized Official - Phone:786-558-8257
Mailing Address - Street 1:15155 NW 7TH AVE UNIT 1A
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-6201
Mailing Address - Country:US
Mailing Address - Phone:786-558-8257
Mailing Address - Fax:786-224-2811
Practice Address - Street 1:15155 NW 7TH AVE UNIT 1A
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-6201
Practice Address - Country:US
Practice Address - Phone:786-558-8257
Practice Address - Fax:786-224-2811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-04
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCBHCMSMedicaid