JESSIE TRICE COMMUNITY HEALTH SYSTEM INC (NPI# 1760644397) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760644397 |
| Entity Type | Organization |
| Organization Name | JESSIE TRICE COMMUNITY HEALTH SYSTEM INC |
| Other Organization Name | JESSIE TRICE COMMUNITY HEALTH CENTER INC |
| Practice Address |
15800 Nw 42nd Ave Miami Gardens FL 33054-6155 |
| Mailing Address |
5607 Nw 27th Ave Ste 1 Miami FL 33142-2826 |
| Practice Telephone | 3056376400 |
| Practice Fax Number | 3058051715 |
| Mailing Telephone | 3058051700 |
| Mailing Fax Number | 3058051715 |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2020-03-18 |
| Authorized Official Name | ANNIE R NEASMAN (PRESIDENT AND CEO) |
| Authorized Official Telephone | 3058051700 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 029542601 | 05 | |
| FL | 029542600 | 05 |
| Other Name | Type Code |
|---|---|
| Jessie Trice Community Health Center Inc | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306452438 | Jessie Trice Community Health System Inc | Clinic/Center | 5361 Nw 22nd Ave # M1, Miami, FL 33142-8035 | 2020-09-23 |
| 1952767402 | Jessie Trice Community Health System Inc | Clinic/Center | 1400 Nw 36th St, Miami, FL 33142-5558 | 2016-01-13 |
| 1861863458 | Jessie Trice Community Health System Inc | Clinic/Center | 3301 Nw 183rd Street, Carol City, FL 33056-2999 | 2015-10-08 |
| 1821498999 | Jessie Trice Community Health System Inc | Clinic/Center | 2520 Nw 75th Street, Miami, FL 33147-0000 | 2014-08-26 |
| 1760645550 | Jessie Trice Community Health System Inc | Clinic/Center | 5607 Nw 27th Ave Ste 2, Miami, FL 33142-2826 | 2008-07-02 |
| 1467614099 | Jessie Trice Community Health System Inc | Clinic/Center | 1190 Nw 95th St Ste 304, Miami, FL 33150-2066 | 2008-06-25 |
| 1790988855 | Jessie Trice Community Health System Inc | Counselor | 2985 Nw 54th St, Miami, FL 33142-2827 | 2007-06-07 |
| 1649328360 | Jessie Trice Community Health System Inc | Counselor | 5361 Nw 22 Avenue, Miami, FL 33142 | 2007-01-08 |
| 1962910141 | Jessie Trice Community Health System Inc | Clinic/Center | 217 Nw 15th St, Miami, FL 33136-1832 | 2018-01-22 |
| 1609247329 | Jessie Trice Community Health System Inc | Clinic/Center | 1100 Nw 71st St, Miami, FL 33150-3894 | 2015-10-08 |
| Street Address |
15800 NW 42ND AVE |
| City | MIAMI GARDENS |
| State | FL |
| Zip Code | 33054-6155 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790318673 | Gretel Ann Briand | Specialist/Technologist | 15800 Nw 42nd Ave, Miami Gardens, FL 33054-6155 | 2020-02-19 |
| 1518503788 | Tamara Jacob | Specialist/Technologist | 15800 Nw 42nd Ave, Miami Gardens, FL 33054-6155 | 2019-11-22 |
| 1619472644 | Florida Memorial University | Orthopaedic Surgery | 15800 Nw 42nd Ave, Miami Gardens, FL 33054-6155 | 2018-03-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770148611 | Arc Dialysis North Dade LLC | Clinic/Center | 1986 Opa Locka Blvd, Opa Locka, FL 33054 | 2019-05-07 |
| 1497215735 | Empowering Minds, Inc | Community/Behavioral Health | 13311 Alexandria Dr, Opa Locka, FL 33054 | 2019-03-22 |
| 1366976672 | Center for Family and Child Enrichment Inc. | Community/Behavioral Health | 3999 Northwest 163st, Miami, FL 33054 | 2017-04-13 |
| 1861924748 | Yudeslanni Fernandez Lang | Behavior Technician | 2970 Nw 161 St, Miami, FL 33054 | 2017-03-30 |
| 1811439862 | Ana Alfaro | Behavior Technician | 1155 Kasin St, Opa Locka, FL 33054 | 2016-11-08 |
| 1114376795 | Yanelis Diaz Rodriguez | Behavior Technician | 13920 Nw 22nd Pl, Opa Locka, FL 33054 | 2016-06-06 |
| 1912392986 | Angel Yasiel Ramos | Internal Medicine | 1986 Opa-locka Boulevard, Opa-locka, FL 33054 | 2015-04-06 |
| 1992109409 | Taylor Wilmoth | Specialist/Technologist | 15600 Nw 32nd Avenue, Attn: Taylor Wilmoth, Miami, FL 33054 | 2014-10-13 |
| 1265844997 | J.s Rx Inc | Pharmacy | 1970 Opa Locka Blvd, Opa Locka, FL 33054 | 2014-05-29 |
| 1689877508 | Nuevo Renacer Alf,corp. | Assisted Living Facility | 540 N. Perviz Avenue, Opa Locka, FL 33054 | 2007-06-07 |
| Find all providers in zip 33054 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285056473 | Jessie Trice Community Health System Inc | Clinic/Center | 16401 Nw 37th Ave, Miami Gardens, FL 33054-6313 | 2014-01-08 |
| 1699106088 | Center for Family and Child Enrichment, Inc | Clinic/Center | 1825 Nw 167th St, Miami Gardens, FL 33056 | 2013-12-10 |
| 1639518798 | Jessie Trice Community Health System Inc | Clinic/Center | 4692 Nw 183rd St, Miami Gardens, FL 33055-3054 | 2013-06-21 |
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| 1306452438 | Jessie Trice Community Health System Inc | Clinic/Center | 5361 Nw 22nd Ave # M1, Miami, FL 33142-8035 | 2020-09-23 |
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| Find all providers with the same taxonomy | ||||
| City | MIAMI GARDENS |
| Zip Code | 33054 |
Please comment or provide details below to improve the information on JESSIE TRICE COMMUNITY HEALTH SYSTEM INC.
| 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.