Organization
JESSIE TRICE COMMUNITY HEALTH SYSTEM INC
Active
Other names
Jessie Trice Community Health Center, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
ANNIE R NEASMAN (PRESIDENT AND CEO)
(305) 805-1700
Entity
Organization
Contact information
Practice address
1190 NW 95TH ST, SUITE 100, MIAMI, FL 33150-2063
(305) 637-6400
(305) 805-1715
Mailing address
5607 NW 27TH AVE, SUITE 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
—
029541804
—
FL
05
—
029541805
—
FL
Enumeration date
07/02/2008
Last updated
12/07/2018
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