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General NPI Number Information
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NPI Number | 1649194911
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Entity Type | Organization
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Legal Business Name | JESSIE TRICE COMMUNITY HEALTH SYSTEM, INC
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Dates
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Enumeration Date | 08/07/2026
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Last Update Date | 08/07/2026
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Provider Practice Location Address
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Address Line | 9536 NE 2ND AVE
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City | MIAMI SHORES
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State | FL
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Zip | 33138-2705
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Country | US
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Telephone | 305-637-6400
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Fax | 305-636-5155
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Provider Business Mailing Address
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Address Line | 5607 NW 27TH AVE STE 1
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City | MIAMI
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State | FL
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Zip | 33142-2826
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Country | US
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Telephone | 305-637-6400
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Fax | 305-835-1598
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | RYAN HAWKINS
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Credential |
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Telephone | 305-805-1700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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