Provider Demographics
NPI:1720529571
Name:SOUTH FLORIDA CASE MANAGEMENT SERVICES, INC.
Entity Type:Organization
Organization Name:SOUTH FLORIDA CASE MANAGEMENT SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:A
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-482-8821
Mailing Address - Street 1:13353 SW 42ND ST UNIT 13365
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3204
Mailing Address - Country:US
Mailing Address - Phone:786-482-8821
Mailing Address - Fax:786-482-3331
Practice Address - Street 1:13353 SW 42ND ST UNIT 13365
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3204
Practice Address - Country:US
Practice Address - Phone:786-482-8821
Practice Address - Fax:786-482-3331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-13
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL103K00000X
251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty