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General NPI Number Information
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NPI Number | 1992034466
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Entity Type | Organization
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Legal Business Name | JACKSON MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 12/13/2009
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Last Update Date | 12/13/2009
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Provider Practice Location Address
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Address Line | 2101 BRICKELL AVE 712
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City | MIAMI
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State | FL
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Zip | 33129-2128
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Country | US
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Telephone | 786-426-7562
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Fax |
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Provider Business Mailing Address
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Address Line | 2101 BRICKELL AVE 712
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City | MIAMI
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State | FL
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Zip | 33129-2128
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Country | US
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Telephone | 786-426-7562
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Fax |
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Authorized Official
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Title or Position | RESIDENT PHYSICIAN IN OBGYN
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Name | ENRIQUE VAZQUEZ-VERA
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Credential | M.D.
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Telephone | 786-426-7562
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NW0100X
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Taxonomy Name | Women's Hospital
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License Number | TRN10207
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License Number State | FL
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