MEDICARE: JACKSON HEALTH SYSTEM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282N00000X	General Acute Care Hospital	1268932	FL

General Provider Information

NPI Number	:	1558381848
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JACKSON HEALTH SYSTEM

Provider Business Mailing Address
First Line	:	11685 NE 21ST DR
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33181-3209
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11685 NE 21ST DR
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33181-3209
Country	:	US
Telephone Number	:	305-355-5220
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF NURSING
Name	:	JULIE MANN
Credential	:
Telephone Number	:	305-585-6856

Provider Enumeration Date	:	07/20/2006
Last Update Date	:	08/22/2020

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Directions to “JACKSON HEALTH SYSTEM ” Practice Location

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