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General NPI Number Information
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NPI Number | 1063417483
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Entity Type | Organization
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Legal Business Name | PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY FLORIDA
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Dates
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Enumeration Date | 06/14/2005
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Last Update Date | 09/04/2020
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Provider Practice Location Address
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Address Line | 15055 NW 27 AVENUE
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City | OPA-LOCKA
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State | FL
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Zip | 33054-3365
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Country | US
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Telephone | 305-466-2800
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Fax | 786-466-2748
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Provider Business Mailing Address
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Address Line | P.O. BOX 12493
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City | MIAMI
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State | FL
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Zip | 33101-2493
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MR. MARK T KNIGHT
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Credential |
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Telephone | 305-585-7979
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number | 8511
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 8511
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | 8511
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 8511
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License Number State | FL
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