Organization
JACKSON MEMORIAL HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER REILLY R.D. (DIETITIAN)
(718) 349-3674
Entity
Organization
Contact information
Practice address
1611 NW 12TH AVE, MIAMI, FL 33136-1005
(305) 585-1111
Mailing address
1611 NW 12TH AVE, MIAMI, FL 33136-1005
(305) 585-1111
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
ND5329
FL
Other
Enumeration date
11/18/2008
Last updated
11/18/2008
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