# ST. JOHN CLINIC MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760470652
- **Authorized official:** MR. REYNALDO CRUZ (CEO)
- **Authorized official phone:** (305) 576-0231

## Contact information

- **Practice address:** 161 NW 29TH ST, MIAMI, FL 33127-3929
- **Practice address phone:** (305) 576-0231
- **Practice address fax:** (305) 573-1458
- **Mailing address:** 161 NW 29TH ST, MIAMI, FL 33127-3929
- **Mailing address phone:** (305) 576-0231
- **Mailing address fax:** (305) 573-1458

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | FL | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | FL | Yes |
| 261QP2300X | Primary Care Clinic/Center | — | FL | — |

## Other

- **Enumeration date:** 10/13/2005
- **Last updated:** 07/21/2022