JACKSON MEMORIAL


Address: 1401 Bay Rd, 510, Miami Beach, FL 33139-3715
Phone: 3059960948

JACKSON MEMORIAL (NPI# 1477641587) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1477641587
Entity Type Organization
Organization Name JACKSON MEMORIAL
Practice Address 1401 Bay Rd
510
Miami Beach
FL 33139-3715
Mailing Address 1401 Bay Rd
510
Miami
FL 33139-3715
Practice Telephone 3059960948
Mailing Telephone 3059960948
Enumeration Date 2006-10-11
Last Update Date 2020-08-22
Authorized Official Name MR. KENNETH JAMES MILLER (STAFF C.R.N.A.)
Authorized Official Telephone 305-585-6586
Authorized Official Credential C.R.N.A.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 282NC0060X General Acute Care Hospital
Specialization: Critical Access
2777352 FL Hospitals

Other Data Sources

Entity Type Entity Name Entity Address
New York State Corporations JACKSON MEMORIAL AME ZION DEVELOPMENT CORPORATION 60 Peninsula Blvd., Hempstead, Ny 11550

Office Location

Street Address 1401 BAY RD
510
City MIAMI BEACH
State FL
Zip Code 33139-3715

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NPI Name Taxonomy Address Enumeration
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1285153239 Stella Kocovic Villacorta Internal Medicine 709 Alton Road, Suite 440, Miami Beach, FL 33139 2017-09-11
1922524164 Noel De Leon Pharmacist 730 15 Street Apt 1-d, Miami Beach, FL 33139 2017-08-18
1861916868 Susana Cruz Behavior Technician 710 Washinghton Ave Apt# 223, Miami Beach, FL 33139 2017-08-01
1730627530 Viviana Yerex Behavior Technician 800 West Ave. Apt. 602, Miami Beach, FL 33139 2017-02-01
1841662921 Miami Beach Holistic Addiction Treatment Center Substance Abuse Rehabilitation Facility 309 23rd Street Ste 200-c, Miami Beach, FL 33139 2015-10-28
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Taxonomy Information

Taxonomy Code 282NC0060X
Grouping Hospitals
Classification General Acute Care Hospital
Specialization Critical Access

Taxonomy Definition

Definition to come.
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1477670099 Memorial Healthcare System General Acute Care Hospital 100 Lincoln Rd, Apt 338, Miami Beach, FL 33139-2013 2007-03-26

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1952850828 Tanya Kischa Bethel-hall General Acute Care Hospital 3094 Nw 72nd Ave, Margate, FL 33063-7878 2016-10-03
1033663752 Uf Health General Acute Care Hospital 3529 Nw 42nd Ter, Gainesville, FL 32606-8131 2016-08-10
1902103583 Lee Memorial General Acute Care Hospital 13681 Doctors Way Ste 16043, Fort Myers, FL 33912-4300 2011-02-17
1477871069 Jackson Memorial Hospital General Acute Care Hospital 4304 E Whitewater Ave, Weston, FL 33332-2409 2010-05-07
1194953828 Mount Sinai Medical Center General Acute Care Hospital 14700 Ne 9th Ave, Miami, FL 33161-2316 2009-07-01
1518157551 Malcom Randall Va Medical Center General Acute Care Hospital 1601 S.w Archer Road, Gainesville, FL 32608-1135 2007-07-26
1720288921 Joanne Lynn Brousseau General Acute Care Hospital 221 6th Ave S Apt E, Jacksonville, FL 32250-6664 2007-07-25
1306046131 Jackson Hospital General Acute Care Hospital 10730 Sw 30th Pl, Davie, FL 33328-1536 2007-07-19
1649480146 St Mary Surgical Inc General Acute Care Hospital 5343 59th Circle West, Kenneth City, FL 33709 2007-05-23
1477618387 Department of Va, Miami Va Health Care General Acute Care Hospital 12530 Ne 1st, Miami, FL 33161 2006-12-22
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Competitor

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City MIAMI BEACH
Zip Code 33139

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Dataset Information

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.

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