| Jackson Health Systems Jackson Memorial Hospita | |
|
1611 Nw 12th Street Miami FL 33136-1005 | |
| (305) 585-8957 | |
| (305) 585-5137 |
| Full Name | Jackson Health Systems Jackson Memorial Hospita |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 1611 Nw 12th Street, Miami, Florida |
| Authorized Official Name and Position | Mark T Knight (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 3055857979 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jackson Health Systems Jackson Memorial Hospita Po Box 12493 Miami FL 33101-2493 Ph: (786) 466-8080 | Jackson Health Systems Jackson Memorial Hospita 1611 Nw 12th Street Miami FL 33136-1005 Ph: (305) 585-8957 |
| NPI Number | 1225033020 |
|---|---|
| Provider Enumeration Date | 06/17/2005 |
| Last Update Date | 04/06/2017 |
| Medicare PECOS PAC ID | 8628981925 |
|---|---|
| Medicare Enrollment ID | O20060208000214 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225033020 | NPI | - | NPPES |
| 010042100 | Medicaid | FL | |
| 010042101 | Medicaid | FL | |
| 010042146 | Medicaid | FL |
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