NPIMap

Organization Active NPI

Jackson Health System

  • Health Service Clinic/Center
  • Miramar, FL
National Provider Identifier
1669481008
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
1706182 Issued in FL
Legal business name
JACKSON HEALTH SYSTEM
Practice address
9771 Glacier Dr
Miramar, FL 33025-4410
Phone
(954) 554-6416
NPI assigned
Aug 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Authorized official

Name
Mrs. Daphne Leonie Reynolds, ARNP
Title
Arnp
Phone
(786) 263-4935

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X 1706182 FL Primary

Addresses

Primary practice location

9771 Glacier Dr
Miramar, FL 33025-4410

Mailing address

9771 Glacier Dr
Miramar, FL 33025-4410
Phone (954) 554-6416

Other names 1

  • none Other name

National Provider Directory

National Provider Directory
Tax ID family
Tara Littlejohn Gonzales MD - Arbor Pediatrics107 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 10

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

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1669481008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9771 GLACIER DR",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330254410",
            "telephone_number": "954-554-6416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9771 GLACIER DR",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330254410",
            "telephone_number": "954-554-6416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2023-09-06",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "DAPHNE",
        "authorized_official_middle_name": "LEONIE",
        "authorized_official_title_or_position": "ARNP",
        "authorized_official_telephone_number": "786-263-4935",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "FL",
            "license": "1706182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "none",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Miramar, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.