NPIMap

Organization Active NPI

Public Health Trust of Dade County Florida

Doing business as Jackson Memorial Hospital

  • Institutional Pharmacy
  • Miami, FL
National Provider Identifier
1679647176
Registry record updated Jun 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Institutional PharmacyTaxonomy code 3336I0012X
License
0829 Issued in FL
Legal business name
PUBLIC HEALTH TRUST OF DADE COUNTY FLORIDA
Doing business as
Jackson Memorial Hospital
Practice address
1611 NW 12TH Ave
Pharmacy Room West Wing B-10
Miami, FL 33136-1005
Phone
(305) 585-7458
NPI assigned
Nov 17, 2006
Last updated
Jun 9, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2009

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

Authorized official

Name
Dr. Eneida O Roldan, M.D.
Title
President Ceo
Phone
(305) 585-6754

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Institutional Pharmacy 3336I0012X 0829 FL Primary
Specialty Pharmacy 3336S0011X 0829 FL

Addresses

Primary practice location

1611 NW 12TH Ave
Pharmacy Room West Wing B-10
Miami, FL 33136-1005

Mailing address

1611 NW 12TH Ave
Pharmacy Room Et Basement 069
Miami, FL 33136-1005
Phone (305) 585-7458

Other names 1

  • Jackson Memorial Hospital Doing business as

National Provider Directory

National Provider Directory
Tax ID family
David E Perloff54 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

1611 NW 12th Ave
Rm Et
Miami, FL 33136

1611 NW 12th Ave
Rm W
Miami, FL 33136
Phone (305) 585-7458

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244505600000",
    "number": "1679647176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "address_2": "PHARMACY ROOM ET BASEMENT 069",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361005",
            "telephone_number": "305-585-7458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "address_2": "PHARMACY ROOM WEST WING B-10",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361005",
            "telephone_number": "305-585-7458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUBLIC HEALTH TRUST OF DADE COUNTY FLORIDA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2009-06-09",
        "status": "A",
        "authorized_official_last_name": "ROLDAN",
        "authorized_official_first_name": "ENEIDA",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "305-585-6754",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "FL",
            "license": "0829",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "FL",
            "license": "0829",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jackson Memorial Hospital",
            "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 Jun 9, 2009; 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.