NPIMap

Organization Active NPI

Public Health Trust of Miami Dade County Florida

Doing business as Jackson Diagnostic Center at Coral Gables

  • Diagnostic Radiology Physician
  • Coral Gables, FL
National Provider Identifier
1619774486
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY FLORIDA
Doing business as
Jackson Diagnostic Center at Coral Gables
Practice address
3737 SW 8TH St Ste C
Coral Gables, FL 33134-3129
Phone
(305) 575-1600
NPI assigned
Feb 27, 2025
Last updated
Jul 28, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

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

Authorized official

Name
Mr. Mark T Knight, CFO
Title
Executive VP, Cfo
Phone
(305) 585-8490

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X NU Primary

Addresses

Primary practice location

3737 SW 8TH St Ste C
Coral Gables, FL 33134-3129

Mailing address

PO Box 12493
Miami, FL 33101-2493
Phone (305) 585-5315

Other identifiers 1

IdentifierTypeStateIssuer
010042158MedicaidFL

Other names 1

  • Jackson Diagnostic Center at Coral Gables Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171025000826 FL Part B Supplier - Hospital Department(S) 8628981925 Receives reassigned benefits from 45 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Miami, FL; North Miami, FL; Miami Gardens, FL; Miami Beach, FL; Doral, FL; Cutler Bay, FL; Coral Gables, FL

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Abdul Mmemon MD54 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

3737 SW 8th St
Ste C
Coral Gables, FL 33134
Phone (305) 575-1600

NPI Registry JSON

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

{
    "created_epoch": "1740614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785196800000",
    "number": "1619774486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12493",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331012493",
            "telephone_number": "305-585-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 SW 8TH ST STE C",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331343129",
            "telephone_number": "305-575-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY FLORIDA",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-27",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A",
        "authorized_official_last_name": "KNIGHT",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "EXECUTIVE VP, CFO",
        "authorized_official_telephone_number": "305-585-8490",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010042158",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jackson Diagnostic Center at Coral Gables",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Coral Gables, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.