| Jessie Trice Community Health System Inc | |
|
20612 Nw 27th Ave Miami Gardens FL 33056-1469 | |
| (305) 637-6400 | |
| (305) 636-5155 |
| Full Name | Jessie Trice Community Health System Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 20612 Nw 27th Ave, Miami Gardens, Florida |
| Authorized Official Name and Position | Annie R Neasman (PRESIDENT/CEO) |
| Authorized Official Contact | 3056376400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jessie Trice Community Health System Inc 5607 Nw 27th Ave Suite 1 Miami FL 33142-2826 Ph: (305) 637-6400 | Jessie Trice Community Health System Inc 20612 Nw 27th Ave Miami Gardens FL 33056-1469 Ph: (305) 637-6400 |
| NPI Number | 1639518798 |
|---|---|
| Provider Enumeration Date | 06/21/2013 |
| Last Update Date | 03/23/2022 |
| Medicare PECOS PAC ID | 2961486733 |
|---|---|
| Medicare Enrollment ID | O20140403000010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639518798 | NPI | - | NPPES |
| 029541846 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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