NPIMap

Organization Active NPI

Jackson Memorial Hospital

  • Critical Access Hospital
  • Miami, FL
National Provider Identifier
1205092186
Registry record updated Jul 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
G235559478070 Issued in FL
Legal business name
JACKSON MEMORIAL HOSPITAL
Practice address
1611 NW 12TH Ave
Acc East Room 102
Miami, FL 33136-1005
Phone
(305) 585-5241
Fax
(305) 585-5112
NPI assigned
Jul 31, 2008
Organization subpart
Yes
Parent organization
CARE AND TREATMENT NETWORKAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 31, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Marie -Yolaine Gaston, MASTER /MPH
Title
Pac Waiver Case Manager
Phone
(305) 585-5241

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X G235559478070 FL Primary

Addresses

Primary practice location

1611 NW 12TH Ave
Acc East Room 102
Miami, FL 33136-1005

Mailing address

1611 NW 12TH Ave
Acc East Room 102
Miami, FL 33136-1005
Phone (305) 585-5241

Other names 1

  • South Florida AIDS Network Doing business as

National Provider Directory

National Provider Directory

Locations

1611 NW 12th Ave
Rm 102
Miami, FL 33136
Phone (305) 585-5241

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1217462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217462400000",
    "number": "1205092186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "address_2": "ACC EAST ROOM 102",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361005",
            "telephone_number": "305-585-5241",
            "fax_number": "305-585-5112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "address_2": "ACC EAST ROOM 102",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361005",
            "telephone_number": "305-585-5241",
            "fax_number": "305-585-5112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CARE AND TREATMENT NETWORK",
        "enumeration_date": "2008-07-31",
        "last_updated": "2008-07-31",
        "status": "A",
        "authorized_official_last_name": "GASTON",
        "authorized_official_first_name": "MARIE -YOLAINE",
        "authorized_official_title_or_position": "PAC WAIVER CASE MANAGER",
        "authorized_official_telephone_number": "305-585-5241",
        "authorized_official_credential": "MASTER /MPH"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "FL",
            "license": "G235559478070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Florida AIDS Network",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.