Provider Demographics
NPI:1548310295
Name:JEWISH COMMUNITY SERVICES OF S FL
Entity type:Organization
Organization Name:JEWISH COMMUNITY SERVICES OF S FL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GRANTS SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-899-1587
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:305-740-8998
Mailing Address - Fax:305-899-6367
Practice Address - Street 1:7875 SW 104TH ST STE 101
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-2642
Practice Address - Country:US
Practice Address - Phone:305-740-8998
Practice Address - Fax:305-899-6367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC5251251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLJ041478OtherINTEGRATED HEALTH PLAN
FL6281690OtherUNITED HEALTH CARE
NYS5826OtherEMPIRE BCBS
FL97034OtherBCBS OF FL
FL590637868OtherUMBH BEHAVIORAL HEALTH
FL0752843 00Medicaid
NYS5826OtherEMPIRE BCBS
FL=========OtherCIGNA BEHAVIORAL HEALTH
NYS5826OtherEMPIRE BCBS