Provider Demographics
NPI:1821667981
Name:MIAMI BEACH COMMUNITY HEALTH CENTER INC
Entity Type:Organization
Organization Name:MIAMI BEACH COMMUNITY HEALTH CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR EVP OF HUMAN RESOURCES
Authorized Official - Prefix:
Authorized Official - First Name:LIZEL
Authorized Official - Middle Name:VIONET
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:HR
Authorized Official - Phone:305-283-4749
Mailing Address - Street 1:11645 BISCAYNE BLVD STE 207
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-3138
Mailing Address - Country:US
Mailing Address - Phone:305-538-8835
Mailing Address - Fax:305-938-4044
Practice Address - Street 1:11645 BISCAYNE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-3155
Practice Address - Country:US
Practice Address - Phone:305-538-8835
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-23
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)