Organization · NPI-2

Banyan Community Health Center, INC.

Clinic/Center, Federally Qualified Health Center (FQHC) · Coral Gables, FL

NPI number1104247188
StatusActive
Last updated in NPPESOct 8, 2026

Details

NPI
1104247188
Entity type
Organization (NPI-2)
Legal business name
Banyan Community Health Center, INC.
Organization subpart
No
Enumeration date
Dec 18, 2013
Certification date
Oct 8, 2026
Last updated
Oct 8, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC)––Yes
251S00000X Community/Behavioral Health––

Practice location

3733 W Flagler St
Coral Gables, FL 33134-1601

Phone 305-398-6100 · Fax 305-398-6099

Mailing address

1200 Nw 78th Ave Ste 100
Doral, FL 33126-1816

Phone 305-398-6100

Authorized official

Manuel Andres Fernandez
Ceo
5612139211

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Clinic/Center, Federally Qualified Health Center (FQHC) providers in Coral Gables, FL