Organization
JESSIE TRICE COMMUNITY HEALTH SYSTEM INC
Active
Other names
JTCHS Children Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN R HAWKINS (PRESIDENT AND CEO)
(305) 805-1700
Entity
Organization
Contact information
Practice address
1190 NW 95TH ST STE 304, MIAMI, FL 33150-2066
(305) 637-6400
(305) 636-5155
Mailing address
5607 NW 27TH AVE, STE 1, MIAMI, FL 33142-2826
(305) 805-1700
(305) 805-1715
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
029541806
—
FL
Enumeration date
06/25/2008
Last updated
11/26/2024
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