Organization
PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY FLORIDA
Active
Parent organization
PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY
Other names
Jackson Memorial Hospital Pedi Renal
Organization subpart
Yes
Provider details
NPI number
Legal business name
PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY
Authorized official
MR. MARK T KNIGHT (CHIEF FINANCIAL OFFICER)
(305) 585-7979
Entity
Organization
Contact information
Practice address
1611 NW 12TH STREET, MIAMI, FL 33136-1005
(305) 585-8490
(305) 355-2377
Mailing address
PO BOX 12493, MIAMI, FL 33101-2493
(786) 466-8080
(305) 355-5380
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
3998
FL
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010042100
—
FL
Enumeration date
11/08/2006
Last updated
04/06/2017
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