| Jessie Trice Community Health System Inc | |
|
5607 Nw 27th Ave Ste 1 Miami FL 33142-2826 | |
| (305) 805-1700 | |
| (305) 805-1715 |
| Full Name | Jessie Trice Community Health System Inc |
|---|---|
| Speciality | Dentist |
| Location | 5607 Nw 27th Ave Ste 1, Miami, Florida |
| Authorized Official Name and Position | Annie Neasman (PRESIDENT/CEO) |
| Authorized Official Contact | 3058051700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jessie Trice Community Health System Inc 5607 Nw 27th Ave Ste 1 Miami FL 33142-2826 Ph: (305) 805-1700 | Jessie Trice Community Health System Inc 5607 Nw 27th Ave Ste 1 Miami FL 33142-2826 Ph: (305) 805-1700 |
| NPI Number | 1568842615 |
|---|---|
| Provider Enumeration Date | 06/04/2015 |
| Last Update Date | 01/26/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568842615 | NPI | - | NPPES |
| 072897700 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN12903 (Florida) | Primary |
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