Organization
PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY FLORIDA
Active
Other names
Jackson South OB/GYN Practice
Organization subpart
No
Provider details
NPI number
Authorized official
MARK T KNIGHT (EVP CHEIF FINANCIAL OFFICER)
(305) 585-7979
Entity
Organization
Contact information
Practice address
15155 SW 97TH AVE STE 230, MIAMI, FL 33176-7016
(305) 585-5259
Mailing address
PO BOX 12493, MIAMI, FL 33101-2493
(786) 466-8101
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Enumeration date
06/22/2021
Last updated
06/22/2021
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