MEDICARE: JOAS MEDICAL CENTER

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	261Q00000X	Clinic/Center	0000001861	FL

General Provider Information

NPI Number	:	1720029036
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOAS MEDICAL CENTER

Provider Business Mailing Address
First Line	:	209 NE 95TH ST
Second Line	:
City	:	MIAMI SHORES
State	:	FL
Zip	:	33138-2745
Country	:	US
Telephone Number	:	305-298-4345
Fax Number	:

Provider Business Practice Location Address
First Line	:	209 NE 95TH ST
Second Line	:
City	:	MIAMI SHORES
State	:	FL
Zip	:	33138-2745
Country	:	US
Telephone Number	:	305-298-4345
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	KENIA ROMERO
Credential	:
Telephone Number	:	305-298-4345

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	08/22/2020

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Directions to “JOAS MEDICAL CENTER ” Practice Location

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