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NPI Code Detail

MEDICARE: PUBLIC HEALTH TRUST OF DADE COUNTY FLORIDA

MEDICARE: PUBLIC HEALTH TRUST OF DADE COUNTY FLORIDA
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
13336C0002XClinic Pharmacy19439FL

General Provider Information

NPI Number : 1659446839
Entity Type Code : Organization
Provider Name (Legal Business Name) : PUBLIC HEALTH TRUST OF DADE COUNTY FLORIDA
Provider Business Mailing Address
First Line : 15055 NW 27TH AVE
Second Line :
City : OPA LOCKA
State : FL
Zip : 33054-3365
Country : US
Telephone Number : 786-466-2701
Fax Number :
Provider Business Practice Location Address
First Line : 15055 NW 27TH AVE
Second Line :
City : OPA LOCKA
State : FL
Zip : 33054-3365
Country : US
Telephone Number : 786-466-2701
Fax Number :
Authorized Official
Title or Position : PRESIDENT CEO
Name : DR. ENEIDA O ROLDAN
Credential : MD
Telephone Number : 305-585-6754
Provider Enumeration Date : 11/22/2006
Last Update Date : 06/09/2009

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1720970312 — MS. MICKELL TERESA SWEETING LCSW
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Directions to “PUBLIC HEALTH TRUST OF DADE COUNTY FLORIDA ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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