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General NPI Number Information
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NPI Number | 1861727851
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Entity Type | Organization
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Legal Business Name | MIAMI VA HEALTHCARE SYSTEM
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Dates
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Enumeration Date | 10/08/2009
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Last Update Date | 10/08/2009
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Provider Practice Location Address
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Address Line | 1201 NW 16TH ST
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City | MIAMI
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State | FL
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Zip | 33125-1624
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Country | US
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Telephone | 305-575-7700
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Fax | 305-575-3380
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Provider Business Mailing Address
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Address Line | 1201 NW 16TH ST
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City | MIAMI
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State | FL
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Zip | 33125-1624
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Country | US
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Telephone | 305-575-7700
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Fax | 305-575-3380
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Authorized Official
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Title or Position | SOCIAL WORKER
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Name | MR. STEPHEN J JANKOWSKI
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Credential | PH.D, LCSW
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Telephone | 305-575-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2865M2000X
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Taxonomy Name | Military General Acute Care Hospital
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License Number | ISW 5624
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License Number State | FL
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