Healthcare Provider Details

I. General information

NPI: 1831263771
Provider Name (Legal Business Name): PUBLIC HEALTH TRUST OF DADE COUNTY FLORIDA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 04/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1477 NW 8TH AVE
MIAMI FL
33136-1425
US

IV. Provider business mailing address

1951 NW 7TH AVE SUITE 160, BOX 140
MIAMI FL
33136-1104
US

V. Phone/Fax

Practice location:
  • Phone: 305-585-8957
  • Fax: 305-585-5259
Mailing address:
  • Phone: 305-355-5222
  • Fax: 305-355-5380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. MARK T KNIGHT
Title or Position: EXECUTIVE VP, CFO
Credential:
Phone: 305-585-8490