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General NPI Number Information
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NPI Number | 1295806016
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Entity Type | Organization
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Legal Business Name | PUBLIC HEALTH TRUST OF DADE COUNTY FLORIDA
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 03/18/2019
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Provider Practice Location Address
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Address Line | 16555 NW 25TH AVE
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City | OPA LOCKA
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State | FL
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Zip | 33054-6583
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Country | US
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Telephone | 786-466-1735
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Fax | 806-242-0502
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Provider Business Mailing Address
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Address Line | PO BOX 864781
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City | ORLANDO
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State | FL
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Zip | 32886-4781
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Country | US
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Telephone | 806-324-5507
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Fax | 806-324-5495
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Authorized Official
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Title or Position | ASSOCIATE DIRECTOR PHARMACY
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Name | STEVEN NEMEROFF
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Credential |
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Telephone | 305-585-6780
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number | PH23948
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License Number State | FL
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