Healthcare Provider Details

I. General information

NPI: 1982146585
Provider Name (Legal Business Name): PUBLIC HEALTH TRUST OF MIAMI CONTY FLORIDA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2016
Last Update Date: 04/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16555 NW 25TH AVE
MIAMI GARDENS FL
33054-6583
US

IV. Provider business mailing address

PO BOX 12493
MIAMI FL
33101-2493
US

V. Phone/Fax

Practice location:
  • Phone: 305-585-8859
  • Fax: 305-355-5380
Mailing address:
  • Phone: 786-466-8080
  • Fax: 305-355-2377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. MARK T KNIGHT
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 305-585-7979