Provider Demographics
NPI:1831167246
Name:JEWISH COMMUNITY SERVICES OF SOUTH FLORIDA, INC.
Entity type:Organization
Organization Name:JEWISH COMMUNITY SERVICES OF SOUTH FLORIDA, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SIXTO
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-403-6513
Mailing Address - Street 1:7875 SW 104TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-2642
Mailing Address - Country:US
Mailing Address - Phone:305-899-1587
Mailing Address - Fax:305-899-6367
Practice Address - Street 1:12000 BISCAYNE BLVD STE 303
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-2720
Practice Address - Country:US
Practice Address - Phone:305-899-1587
Practice Address - Fax:305-899-6367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-10
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251V00000X, 251S00000X
FL251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL075284300Medicaid
FL97034OtherBCBS OF FL
FL125293900Medicaid
FLJ041478OtherINTEGRATED HEALTH PLAN
FLS5826OtherEMPIRE BCBS