Organization
JACKSON MEMORIAL HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES LYNNE MD (MD- DEPARTMENT OF UROLOGY)
(305) 585-1520
Entity
Organization
Contact information
Practice address
1600 NW 12TH AVE., SUITE C-150, MIAMI, FL 33136
(305) 585-1520
(305) 585-1551
Mailing address
7634 S.W. 106 AVE., MIAMI, FL 33173
(305) 742-5717
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
1646212
FL
282NC0060X
Critical Access Hospital
1646212
FL
Other
Enumeration date
05/24/2007
Last updated
09/11/2025
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