Organization
PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY FLORIDA
Active
Other names
Jackson Health System Infusion Services
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS A MIGOYA (PRESIDENT AND CEO)
(305) 585-6754
Entity
Organization
Contact information
Practice address
1611 NW 12TH AVE STE T-277, MIAMI, FL 33136-1005
(305) 585-5261
Mailing address
PO BOX 12493, MIAMI, FL 33101-2493
(305) 585-5315
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PH35124
PHARMACY LICENSE
FL
Enumeration date
05/24/2024
Last updated
01/31/2025
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