BANYAN COMMUNITY HEALTH CENTER, INC. – NPI #1972979631
Clinic/Center

BANYAN COMMUNITY HEALTH CENTER, INC. is an AHC clinic located in LAUDERDALE LAKES, FL. NPPES has assigned the NPI number 1972979631 to BANYAN COMMUNITY HEALTH CENTER, INC. on August 18, 2015. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QF0400X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Federally Qualified Health Center (FQHC)

The NPI profile was last updated on Apr 15, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for BANYAN COMMUNITY HEALTH CENTER, INC. below.

NPI Profile for
BANYAN COMMUNITY HEALTH CENTER, INC.

NPI Number
1972979631
Enumeration Date

(about 11 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
BANYAN COMMUNITY HEALTH CENTER, INC.
Primary location
4900 W OAKLAND PARK BLVD FL 3
LAUDERDALE LAKES, FL 33313-7500
Phone: (305) 398-6100 Fax:
Mailing address
2300 NW 89TH PL FL 3
DORAL, FL 33172-2431
Phone: (305) 398-6100 Fax:
Organization Subpart
No
Authorized Official
MANUEL FERNANDEZ
CEO
Phone: (561) 213-9211
Updated
Certification Date
Apr 15, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for BANYAN COMMUNITY HEALTH CENTER, INC.

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
medicaidFL013881915
medicaidFL014042500
medicaidFL013881916
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QF0400X
- Clinic/Center / Federally Qualified Health Center (FQHC) (Primary)
251S00000X
- Community/Behavioral Health

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.