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NPI Code Detail

MEDICARE: PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY FLORIDA

MEDICARE: PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY FLORIDA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QC1500XCommunity Health Clinic/Center8511FL
2261QM0850XAdult Mental Health Clinic/Center8511FL
3261QM0855XAdolescent and Children Mental Health Clinic/Center8511FL
4261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)8511FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3142202200OTHERFLASSISTED CARE SERVICES
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063417483
Entity Type Code : Organization
Provider Name (Legal Business Name) : PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY FLORIDA
Provider Business Mailing Address
First Line : P.O. BOX 12493
Second Line :
City : MIAMI
State : FL
Zip : 33101-2493
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 15055 NW 27 AVENUE
Second Line :
City : OPA-LOCKA
State : FL
Zip : 33054-3365
Country : US
Telephone Number : 305-466-2800
Fax Number : 786-466-2748
Authorized Official
Title or Position : CHIEF FINANCIAL OFFICER
Name : MR. MARK T KNIGHT
Credential :
Telephone Number : 305-585-7979
Provider Enumeration Date : 06/14/2005
Last Update Date : 09/04/2020

Similar Medicare Providers

1750397907 — GERDA M WILLIAMS NP
Practice Location Address:
15055 NW 27TH AVE
OPA LOCKA, FL
33054-3365
Practice Phone: 786-466-2800
Practice Fax:
1144328329 — DR. GERALDINE MATTIA MD
Practice Location Address:
15055 NW 27TH AVE
OPA LOCKA, FL
33054-3365
Practice Phone: 786-466-2800
Practice Fax:
1659446839 — PUBLIC HEALTH TRUST OF DADE COUNTY FLORIDA
Practice Location Address:
15055 NW 27TH AVE
OPA LOCKA, FL
33054-3365
Practice Phone: 786-466-2701
Practice Fax:
1487102653 — DIANE GILLES
Practice Location Address:
15055 NW 27TH AVE
OPA LOCKA, FL
33054-3365
Practice Phone: 786-466-2800
Practice Fax:
1568912889 — PERETTE TURENNE
Practice Location Address:
15055 NW 27TH AVE
OPA LOCKA, FL
33054-3365
Practice Phone: 786-466-2800
Practice Fax:
1720970312 — MS. MICKELL TERESA SWEETING LCSW
Practice Location Address:
15055 NW 27TH AVE
OPA LOCKA, FL
33054-3365
Practice Phone: 786-466-2800
Practice Fax: 786-466-2847

Directions to “PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY FLORIDA ” Practice Location

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