Healthcare Provider Details

I. General information

NPI: 1174449326
Provider Name (Legal Business Name): UIVERSITY OF MIAMI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 NW 12TH AVE EAST BUILDING ROOM 4020BB
MIAMI FL
33136-1003
US

IV. Provider business mailing address

1400 NW 12TH AVE EAST BUILDING ROOM 4020BB
MIAMI FL
33136-1003
US

V. Phone/Fax

Practice location:
  • Phone: 305-689-2742
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: MONICA JORDAN
Title or Position: AVP GOVT REPORTING AND REIMB
Credential:
Phone: 615-405-4901