PUBLIC HEALTH TRUST OF DADE COUNTY FLORIDA (NPI# 1053789313) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053789313 |
| Entity Type | Organization |
| Organization Name | PUBLIC HEALTH TRUST OF DADE COUNTY FLORIDA |
| Other Organization Name | JACKSON MEMORIAL HOSPITAL OUTPATIENT PHARMACY |
| Practice Address |
1611 Nw 12th Ave Miami FL 33136-1005 |
| Mailing Address |
Po Box 864781 Orlando FL 32886-4781 |
| Practice Telephone | 3055855890 |
| Practice Fax Number | 8062420502 |
| Mailing Telephone | 8063245507 |
| Mailing Fax Number | 8063245495 |
| Enumeration Date | 2015-09-03 |
| Last Update Date | 2015-09-03 |
| Authorized Official Name | JAN ROBINSON (VP-CONTRACTING) |
| Authorized Official Telephone | 8063245507 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
PH0008215 | FL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2153844 | 01 |
| Other Name | Type Code |
|---|---|
| Jackson Memorial Hospital Outpatient Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871705558 | Public Health Trust of Dade County Florida | Clinic/Center | 14701 Nw 27th Ave, Opa Locka, FL 33054-3350 | 2007-05-04 |
| 1427120856 | Public Health Trust of Dade County Florida | Clinic/Center | 1660 Nw 7th Ct, Highland Pavillion, Miami, FL 33136-1420 | 2006-11-14 |
| 1194897421 | Public Health Trust of Dade County Florida | Legal Medicine | 1851 Nw 10th Ave, Miami, FL 33136-1054 | 2006-11-14 |
| 1295806727 | Public Health Trust of Dade County Florida | Pharmacy | 9333 Sw 152 Street, Miami, FL 33157 | 2006-11-13 |
| 1790856458 | Public Health Trust of Dade County Florida | Pharmacy | 901 Nw 17th St Ste D, Miami, FL 33136-1135 | 2006-11-13 |
| 1124062542 | Public Health Trust of Dade County Florida | Anesthesiology | 1611 Nw 12th Avenue, Miami, FL 33136 | 2006-06-15 |
| 1134116320 | Public Health Trust of Dade County Florida | Skilled Nursing Facility | 2500 Nw 22nd Ave, Miami, FL 33142-8429 | 2005-10-03 |
| 1710358163 | Public Health Trust of Dade County Florida | Clinic/Center | 615 5th St, Miami Beach, FL 33139-6515 | 2015-10-12 |
| 1831340900 | Public Health Trust of Dade County Florida | Clinic/Center | 20201 Nw 37th Ave, Miami Gardens, FL 33056-1755 | 2008-10-07 |
| 1487805651 | Public Health Trust of Dade County Florida | Clinic/Center | 20201 Nw 37th Ave, Miami Gardens, FL 33056-1755 | 2008-10-07 |
| Street Address |
1611 NW 12TH AVE |
| City | MIAMI |
| State | FL |
| Zip Code | 33136-1005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740286251 | Karen Chitty | Emergency Medicine | 1611 Nw 12th Ave, Miami, FL 33136-1005 | 2005-06-21 |
| 1558968263 | Natalie Dinger | Nurse Practitioner | 1611 Nw 12th Ave, Miami, FL 33136-1096 | 2020-10-06 |
| 1306452057 | Ryan M Bukhari | Dentist | 1611 Nw 12th Ave, Miami, FL 33136-1096 | 2020-09-18 |
| 1467068155 | Hussien Touny | Student in an Organized Health Care Education/Training Program | 1611 Nw 12th Ave, Miami, FL 33136-1096 | 2020-09-18 |
| 1912512310 | Clementina Aurora Cabrera | Student in an Organized Health Care Education/Training Program | 1611 Nw 12th Ave, Miami, FL 33136-1005 | 2020-09-11 |
| 1184237265 | Kencya Toussaint | Nurse Practitioner | 1611 Nw 12th Ave, Miami, FL 33136-1096 | 2020-08-28 |
| 1568075976 | Manuel Molina | Student in an Organized Health Care Education/Training Program | 1611 Nw 12th Ave, Miami, FL 33136-1005 | 2020-08-25 |
| 1063025468 | Carlos Federico Moral Ortega | Student in an Organized Health Care Education/Training Program | 1611 Nw 12th Ave, Miami, FL 33136-1096 | 2020-08-25 |
| 1770195919 | Ezekiel Oluwasayo Ijaopo | Student in an Organized Health Care Education/Training Program | 1611 Nw 12th Ave, Miami, FL 33136-1005 | 2020-08-19 |
| 1568070258 | Virosh Dharmadasa | Student in an Organized Health Care Education/Training Program | 1611 Nw 12th Ave, Miami, FL 33136-1005 | 2020-07-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548875685 | Agustina Dirocco | Registered Nurse | 1611 Ne 12th Ave, Miami, FL 33136 | 2020-09-15 |
| 1093338451 | Krizia Amy Vinck | Clinical Neuropsychologist | 1150 Nw 14th St, Miami, Fl 33136, Miami, FL 33136 | 2020-05-20 |
| 1992327761 | Jorge Luis Cardenas Alvarez | Student in an Organized Health Care Education/Training Program | 1611 Nw 12 Avenue Central Room 600-d, Miami, FL 33136 | 2020-05-14 |
| 1104447036 | Denver Steven Pinto | Student in an Organized Health Care Education/Training Program | 1611 Nw 12 Avenue Jackson Memorial Hospital, West Wing 279 Emergency Radiology, Miami, FL 33136 | 2020-05-01 |
| 1992325724 | Dimple Kumar Chanamolu | Student in an Organized Health Care Education/Training Program | Deptarment of Urology University of Miama Miller School, Crb 1120 Nw 14th Street Suite 1551c, Miami, FL 33136 | 2020-04-22 |
| 1578100996 | Alex Aziz Al Khoury | Internal Medicine | 1120 Nw 14th St. Suite 1112, Miami, FL 33136 | 2019-12-04 |
| 1437708872 | Marie Jeanjean | Genetic Counselor, MS | 1501 Nw 10th Avenue, Brb 334 (m860), Miami, FL 33136 | 2019-09-09 |
| 1710543905 | Tal Friehmann | Student in an Organized Health Care Education/Training Program | Jackson Memorial Hospital, Breast Imaging Dep, 1611 Nw 12 Avenue, Miami, FL 33136 | 2019-05-14 |
| 1285297895 | Omar Munoz | Student in an Organized Health Care Education/Training Program | 1611 Nw 12th Av., Psychiatry Department, Miami, FL 33136 | 2019-04-18 |
| 1902369648 | Seyedeh Haleh Amirian | Student in an Organized Health Care Education/Training Program | 1611 12th Avenue, Holtz Buiding, East Tower, 2169, Miami, FL 33136 | 2019-04-10 |
| Find all providers in zip 33136 | ||||
| Taxonomy Code | 3336C0002X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Clinic Pharmacy |
| A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770007486 | Millenium Clinic Pharmacy Inc | Pharmacy | 12914 Sw 133rd Ct Ste B, Miami, FL 33186-6585 | 2017-08-03 |
| 1194069542 | Easy Scripts Westchester, LLC | Pharmacy | 9796 Sw 24th Street, Miami, FL 33165-7500 | 2012-11-23 |
| 1053602664 | Qs Health | Pharmacy | 1900 N Bayshore Dr Apt 3403, Miami, FL 33132-3018 | 2011-04-29 |
| 1154566966 | Bravo Comunications | Pharmacy | 3320 Sw 87th Ave, Miami, FL 33165-4207 | 2008-12-08 |
| 1215328109 | Juventis LLC | Pharmacy | 2251 Sw 27th Ave, Miami, FL 33145-3433 | 2015-02-12 |
| 1013240217 | Leon Medical Centers LLC | Pharmacy | 12515 Sw 88th St, Miami, FL 33186-1870 | 2009-09-08 |
| 1821116716 | Leon Medical Centers LLC | Pharmacy | 11501 Sw 40th St, Miami, FL 33165-3313 | 2007-03-27 |
| 1629102587 | Leon Medical Centers LLC | Pharmacy | 101 Sw 27th Ave, Miami, FL 33135-1428 | 2007-03-15 |
| 1508949835 | Humana Pharmacy Inc | Pharmacy | 1200 Sw 1st St, Miami, FL 33135-2402 | 2006-10-23 |
| 1326121658 | Humana Pharmacy Inc | Pharmacy | 10401 Sw 40th St, Miami, FL 33165-3745 | 2006-10-23 |
| Find all providers in MIAMI | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.