Provider Demographics
NPI:1942338983
Name:BISCAYNE MILIEU HEALTH CENTER, INC.
Entity Type:Organization
Organization Name:BISCAYNE MILIEU HEALTH CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:A
Authorized Official - Last Name:MACLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-948-9000
Mailing Address - Street 1:1000 PARK CENTRE BLVD
Mailing Address - Street 2:SUITE 138
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-5373
Mailing Address - Country:US
Mailing Address - Phone:305-948-9000
Mailing Address - Fax:305-949-2270
Practice Address - Street 1:1000 PARK CENTRE BLVD
Practice Address - Street 2:SUITE 138
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-5373
Practice Address - Country:US
Practice Address - Phone:305-948-9000
Practice Address - Fax:305-949-2270
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:QUALITY CARE NETWORK INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-01
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC3855261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL104732Medicare Oscar/Certification