Active NPI
Jackson Medical Office LLC
- Clinic/Center
- Miami, FL
National Provider Identifier
1841091220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- Legal business name
- JACKSON MEDICAL OFFICE LLC
- Practice address
- 730 NW 107TH Ave Ste 214
Miami, FL 33172-3104 - Phone
- (728) 205-7604
- Fax
- (305) 341-3910
- NPI assigned
- Mar 21, 2025
- Organization subpart
- Yes
- Parent organization
- JACKSON MEDICAL OFFICE LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Jorge P Amaya, ME
- Title
- Ceo
- Phone
- (728) 205-7604
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Primary |
Addresses
Primary practice location
730 NW 107TH Ave Ste 214
Miami, FL 33172-3104
Mailing address
730 NW 107TH Ave Ste 214
Miami, FL 33172-3104
Phone (728) 205-7604
Other practice location 1
730 NW 107th Ave Ste 214
Miami, FL 33172-3104
Phone (728) 205-7604
Other names 1
- Jackson Medical Office LLC
National Provider Directory
National Provider Directory- Part of
- Jackson Medical Office LLC
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Contractor
- Miami, FL
- NPI 1215723465
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1742515200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1742601600000",
"number": "1841091220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "730 NW 107TH AVE STE 214",
"city": "MIAMI",
"state": "FL",
"postal_code": "331723104",
"telephone_number": "728-205-7604",
"fax_number": "305-341-3910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "730 NW 107TH AVE STE 214",
"city": "MIAMI",
"state": "FL",
"postal_code": "331723104",
"telephone_number": "728-205-7604",
"fax_number": "305-341-3910"
}
],
"practiceLocations": [
{
"address_1": "730 NW 107th Ave Ste 214",
"address_purpose": "LOCATION",
"city": "Miami",
"state": "FL",
"postal_code": "331723104",
"country_code": "US",
"telephone_number": "728-205-7604",
"fax_number": "305-341-3910",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "JACKSON MEDICAL OFFICE LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "JACKSON MEDICAL OFFICE LLC",
"enumeration_date": "2025-03-21",
"last_updated": "2025-03-22",
"certification_date": "2025-03-22",
"status": "A",
"authorized_official_last_name": "AMAYA",
"authorized_official_first_name": "JORGE",
"authorized_official_middle_name": "P",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "728-205-7604",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "ME"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Jackson Medical Office LLC",
"code": "4",
"type": "Former Legal Business Name"
}
]
}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 Mar 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.