JACKSON MEMORIAL HOSPITAL


Address: 1611 Nw 12th Ave, East Tower, Miami, FL 33136-1005
Phone: 3055855437

JACKSON MEMORIAL HOSPITAL (NPI# 1366973745) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1366973745
Entity Type Organization
Organization Name JACKSON MEMORIAL HOSPITAL
Practice Address 1611 Nw 12th Ave
East Tower
Miami
FL 33136-1005
Mailing Address 10720 Sw 118th Ct
Miami
FL 33186-3947
Practice Telephone 3055855437
Mailing Telephone 7868634141
Enumeration Date 2017-03-27
Last Update Date 2017-03-27
Authorized Official Name MS. FREDERICA HENNESSY (HUMAN RESOURCES)
Authorized Official Telephone 3055856081
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 3140N1450X Skilled Nursing Facility
Specialization: Nursing Care, Pediatric
Nursing & Custodial Care Facilities

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1306158266 Jackson Memorial Hospital Special Hospital 13128 Sw 45th Dr, Miramar, FL 33027-3160 2010-07-08
1477871069 Jackson Memorial Hospital General Acute Care Hospital 4304 E Whitewater Ave, Weston, FL 33332-2409 2010-05-07
1992034466 Jackson Memorial Hospital General Acute Care Hospital 2101 Brickell Ave, 712, Miami, FL 33129-2128 2009-12-13
1225275639 Jackson Memorial Hospital General Acute Care Hospital 169 E Flagler St Fl 11, Miami, FL 33131-1210 2009-01-08
1861603706 Jackson Memorial Hospital Clinic/Center 1600 Nw 12th Ave., Suite C-150, Miami, FL 33136 2007-05-24
1891879623 Jackson Memorial Hospital General Acute Care Hospital 435 Ne 121st St, Apt 207, North Miami, FL 33161-5480 2006-10-25
1922196062 Jackson Memorial Hospital General Acute Care Hospital 3311 Sw 17th St, Miami, FL 33145-1821 2006-10-11
1477568178 Jackson Memorial Hospital Clinic/Center 13850 Nw 41st St, Doral, FL 33178-3004 2006-07-30
1497033500 Jackson Memorial Hospital Chronic Disease Hospital 1450 Nw 10th Ave, Suite 2054a, Miami, FL 33136-1011 2011-07-25
1528386463 Jackson Memorial Hospital Medicare Defined Swing Bed Unit 1611 Nw 12th Ave, Miami, FL 33136-1005 2010-05-16

Office Location

Street Address 1611 NW 12TH AVE
EAST TOWER
City MIAMI
State FL
Zip Code 33136-1005

Providers in the same location

NPI Name Taxonomy Address Enumeration
1740286251 Karen Chitty Emergency Medicine 1611 Nw 12th Ave, Miami, FL 33136-1005 2005-06-21
1558968263 Natalie Dinger Nurse Practitioner 1611 Nw 12th Ave, Miami, FL 33136-1096 2020-10-06
1306452057 Ryan M Bukhari Dentist 1611 Nw 12th Ave, Miami, FL 33136-1096 2020-09-18
1467068155 Hussien Touny Student in an Organized Health Care Education/Training Program 1611 Nw 12th Ave, Miami, FL 33136-1096 2020-09-18
1912512310 Clementina Aurora Cabrera Student in an Organized Health Care Education/Training Program 1611 Nw 12th Ave, Miami, FL 33136-1005 2020-09-11
1184237265 Kencya Toussaint Nurse Practitioner 1611 Nw 12th Ave, Miami, FL 33136-1096 2020-08-28
1568075976 Manuel Molina Student in an Organized Health Care Education/Training Program 1611 Nw 12th Ave, Miami, FL 33136-1005 2020-08-25
1063025468 Carlos Federico Moral Ortega Student in an Organized Health Care Education/Training Program 1611 Nw 12th Ave, Miami, FL 33136-1096 2020-08-25
1770195919 Ezekiel Oluwasayo Ijaopo Student in an Organized Health Care Education/Training Program 1611 Nw 12th Ave, Miami, FL 33136-1005 2020-08-19
1568070258 Virosh Dharmadasa Student in an Organized Health Care Education/Training Program 1611 Nw 12th Ave, Miami, FL 33136-1005 2020-07-19
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1548875685 Agustina Dirocco Registered Nurse 1611 Ne 12th Ave, Miami, FL 33136 2020-09-15
1093338451 Krizia Amy Vinck Clinical Neuropsychologist 1150 Nw 14th St, Miami, Fl 33136, Miami, FL 33136 2020-05-20
1992327761 Jorge Luis Cardenas Alvarez Student in an Organized Health Care Education/Training Program 1611 Nw 12 Avenue Central Room 600-d, Miami, FL 33136 2020-05-14
1104447036 Denver Steven Pinto Student in an Organized Health Care Education/Training Program 1611 Nw 12 Avenue Jackson Memorial Hospital, West Wing 279 Emergency Radiology, Miami, FL 33136 2020-05-01
1992325724 Dimple Kumar Chanamolu Student in an Organized Health Care Education/Training Program Deptarment of Urology University of Miama Miller School, Crb 1120 Nw 14th Street Suite 1551c, Miami, FL 33136 2020-04-22
1578100996 Alex Aziz Al Khoury Internal Medicine 1120 Nw 14th St. Suite 1112, Miami, FL 33136 2019-12-04
1437708872 Marie Jeanjean Genetic Counselor, MS 1501 Nw 10th Avenue, Brb 334 (m860), Miami, FL 33136 2019-09-09
1710543905 Tal Friehmann Student in an Organized Health Care Education/Training Program Jackson Memorial Hospital, Breast Imaging Dep, 1611 Nw 12 Avenue, Miami, FL 33136 2019-05-14
1285297895 Omar Munoz Student in an Organized Health Care Education/Training Program 1611 Nw 12th Av., Psychiatry Department, Miami, FL 33136 2019-04-18
1902369648 Seyedeh Haleh Amirian Student in an Organized Health Care Education/Training Program 1611 12th Avenue, Holtz Buiding, East Tower, 2169, Miami, FL 33136 2019-04-10
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Taxonomy Information

Taxonomy Code 3140N1450X
Grouping Nursing & Custodial Care Facilities
Classification Skilled Nursing Facility
Specialization Nursing Care, Pediatric

Taxonomy Definition

A nursing care facility designed and staffed for the provision of nursing care and appropriate educational and habilitative/rehabilitative services to children with multiple, complex or profound disabilities that can not be cared for in a less restrictive environment.
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1538786173 Magical Dreams Academy LLC Skilled Nursing Facility 966 Sw 82nd Ave, Miami, FL 33144-4271 2020-06-30
1285261867 Fkppec3, Inc. Skilled Nursing Facility 8681 Coral Way, Miami, FL 33155-2337 2020-03-24
1336794387 South Florida Ppec Services, LLC Skilled Nursing Facility 15383 Nw 7th Ave Ste B, Miami, FL 33169-6205 2019-08-06
1962984211 Specialized Pediatric Care LLC Skilled Nursing Facility 1601 Nw 13th Ct, Miami, FL 33125-1607 2018-09-04
1366810079 Big Bear Academy Skilled Nursing Facility 9300 Sunset Dr, 1st Floor, Miami, FL 33173-3205 2015-09-11
1699752501 Miami Gardens Care Center, Inc. Skilled Nursing Facility 190 Ne 191st St, Miami, FL 33179-3711 2005-12-30
1265056105 Allegre Ppec Inc Skilled Nursing Facility 7411 S Waterway Dr, Miami, FL 33155-2707 2020-06-06

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1437776671 My Extended Family Home Care Skilled Nursing Facility 4766 Golden Gate Pkwy Ste 4, Naples, FL 34116-6935 2020-07-04
1427685692 Fkppec1, Inc. Skilled Nursing Facility 5547 W Oakland Park Blvd, Lauderhill, FL 33313-1411 2020-03-26
1649807215 Fkppec2, Inc. Skilled Nursing Facility 6515 Taft St, Hollywood, FL 33024-4008 2020-03-24
1710527296 Kids Miracle Steps, Inc. Skilled Nursing Facility 1371-1381 N Palm Ave., Pembroke Pines, FL 33024 2020-01-13
1710549019 Caring Hearts Nursing Services LLC Skilled Nursing Facility 5700 Lake Worth Rd Ste 209-4, Greenacres, FL 33463-3270 2019-07-08
1780242982 Florida Kids Ppec, LLC Skilled Nursing Facility 5 E. Lane Dr., Units A/b, Mary Esther, FL 32569 2019-06-03
1871054254 Happy Kids Ppec Foundation Skilled Nursing Facility 4756 Nw 167th St, Miami Lakes, FL 33014-6427 2019-03-27
1467926022 Respiratory Care Providers, Incorporated Skilled Nursing Facility 2401 Frist Blvd Ste 9, Fort Pierce, FL 34950-4844 2019-01-17
1891268264 Angels On Earth Ppec, Inc. Skilled Nursing Facility 12200 Menta St Ste 105, Orlando, FL 32837-7540 2019-01-08
1407361454 Nuvista Living At Jupiter, LLC Skilled Nursing Facility 338 Pioneer Road, Jupiter, FL 33410 2017-12-12
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Competitor

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City MIAMI
Zip Code 33136

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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