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Organization

PUBLIC HEALTH TRUST OF MIAMI 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
1611 NW 12TH AVE, MIAMI, FL 33136-1005
(305) 355-7147
Mailing address
PO BOX 12493, MIAMI, FL 33101-2493
(305) 585-5315

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
106118200
FL
Enumeration date
12/13/2021
Last updated
12/13/2021
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