# PUBLIC HEALTH TRUST OF DADE COUNTY FLORIDA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Jackson Memorial Hospital
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679647176
- **Authorized official:** DR. ENEIDA O ROLDAN M.D. (PRESIDENT CEO)
- **Authorized official phone:** (305) 585-6754

## Contact information

- **Practice address:** 1611 NW 12TH AVE, PHARMACY ROOM WEST WING B-10, MIAMI, FL 33136-1005
- **Practice address phone:** (305) 585-7458
- **Mailing address:** 1611 NW 12TH AVE, PHARMACY ROOM ET BASEMENT 069, MIAMI, FL 33136-1005
- **Mailing address phone:** (305) 585-7458

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336I0012X | Institutional Pharmacy | 0829 | FL | Yes |
| 3336S0011X | Specialty Pharmacy | 0829 | FL | — |

## Other

- **Enumeration date:** 11/17/2006
- **Last updated:** 06/09/2009