=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699003707
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PROJECT ACCESS FOUNDATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/01/2009
-----------------------------------------------------
Last Update Date | 09/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8000 BISCAYNE BLVD
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33138-4621
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-759-4778
-----------------------------------------------------
Fax | 866-457-2305
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1435 W 49TH PL STE 503
-----------------------------------------------------
City | HIALEAH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33012-3158
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-787-3267
-----------------------------------------------------
Fax | 786-953-5323
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | JACK J MICHEL
-----------------------------------------------------
Credential | ME58713
-----------------------------------------------------
Telephone | 305-284-7500
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261Q00000X
-----------------------------------------------------
Taxonomy Name | Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------