Healthcare Provider Details

I. General information

NPI: 1154011971
Provider Name (Legal Business Name): PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY FLORIDA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2023
Last Update Date: 05/15/2023
Certification Date: 02/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3737 SW 8TH ST STE A
CORAL GABLES FL
33134-3121
US

IV. Provider business mailing address

PO BOX 12493
MIAMI FL
33101-2493
US

V. Phone/Fax

Practice location:
  • Phone: 305-585-3701
  • Fax: 305-585-6960
Mailing address:
  • Phone: 786-466-8101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: MARK T KNIGHT
Title or Position: CFO
Credential:
Phone: 305-585-4211