Healthcare Provider Details

I. General information

NPI: 1548900178
Provider Name (Legal Business Name): PUBLIC HEALTH TRUST OF DADE COUNTY FLORIDA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2022
Last Update Date: 04/04/2022
Certification Date: 04/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3737 SW 8TH ST STE B
CORAL GABLES FL
33134-3129
US

IV. Provider business mailing address

PO BOX 12493
MIAMI FL
33101-2493
US

V. Phone/Fax

Practice location:
  • Phone: 305-585-3701
  • Fax:
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: EVP CFO
Credential:
Phone: 305-585-4211