Organization
PUBLIC HEALTH TRUST OF DADE COUNTY FLORIDA
Active
Other names
JMG Specialty Physicians
Organization subpart
No
Provider details
NPI number
Authorized official
MARK T KNIGHT CFO (EXECUTIVE VP, CFO)
(305) 585-8490
Entity
Organization
Contact information
Practice address
2801 NW 79TH AVE, DORAL, FL 33122-1174
(786) 466-1154
Mailing address
PO BOX 12493, MIAMI, FL 33101-2493
(305) 585-5315
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000957226
—
FL
Enumeration date
08/19/2021
Last updated
02/25/2022
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