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Organization
JACKSON MEM HOS
Active
Organization
JACKSON MEM HOS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUDREY VIVIENNE ROBERTS (ARNP)
(305) 585-6677
Entity
Organization
Contact information
Practice address
1611 NW 12TH AVE, MIAMI, FL 33136-1005
(305) 585-6677
Mailing address
10429 OAK MEADOW LN, LAKE WORTH, FL 33467-5470
(561) 968-5169
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Enumeration date
01/22/2007
Last updated
08/22/2020
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