| Jefferson Reaves Sr Health Center | |
|
1009 Nw 5th Ave Miami FL 33136-3212 | |
| (786) 466-4000 | |
| (305) 577-1085 |
| Full Name | Jefferson Reaves Sr Health Center |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 1009 Nw 5th Ave, Miami, Florida |
| Authorized Official Name and Position | Mark T Knight (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 3055857979 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jefferson Reaves Sr Health Center Po Box 12493 Miami FL 33101-2493 Ph: (786) 466-8080 | Jefferson Reaves Sr Health Center 1009 Nw 5th Ave Miami FL 33136-3212 Ph: (786) 466-4000 |
| NPI Number | 1851467666 |
|---|---|
| Provider Enumeration Date | 11/27/2006 |
| Last Update Date | 04/06/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851467666 | NPI | - | NPPES |
| 010042127 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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