PUBLIC HEALTH TRUST OF DADE COUNTY (NPI# 1538494752) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538494752 |
| Entity Type | Organization |
| Organization Name | PUBLIC HEALTH TRUST OF DADE COUNTY |
| Other Organization Name | JACKSON MEMORIAL HOSPITAL PROSTHETIC AND ORTHOTIC LAB |
| Practice Address |
1611 Nw 12th Ave Rehab Building, Room 129 Miami FL 33136-1005 |
| Practice Telephone | 3055856265 |
| Practice Fax Number | 3055852675 |
| Mailing Telephone | 3055856265 |
| Mailing Fax Number | 3055852675 |
| Enumeration Date | 2009-10-06 |
| Last Update Date | 2016-04-22 |
| Authorized Official Name | MR. STEPHEN R DSIDA (LICENSED PROSTHETIST) |
| Authorized Official Telephone | 3055856265 |
| Authorized Official Credential | L.P. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| Other Name | Type Code |
|---|---|
| Jackson Memorial Hospital Prosthetic and Orthotic Lab | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295809606 | Public Health Trust of Dade County | Clinic/Center | 971 Nw 2nd St, Miami, FL 33128-1205 | 2006-11-17 |
| 1770653032 | Public Health Trust of Dade County | Emergency Medicine | 1611 Nw 12th Ave, Miami, FL 33136-1005 | 2006-11-08 |
| 1821174186 | Public Health Trust of Dade County | Transplant Surgery | 1600 S Andrews Ave, Ft Lauderdale, FL 33316-2510 | 2006-10-30 |
| 1497772263 | Public Health Trust of Dade County | Clinic/Center | 6601 Sw 62nd Ave, South Miami, FL 33143-3300 | 2006-07-16 |
| Street Address |
1611 NW 12TH AVE REHAB BUILDING, ROOM 129 |
| City | MIAMI |
| State | FL |
| Zip Code | 33136-1005 |
| 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 |
| Find all providers in the same location | ||||
| 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 |
| Find all providers in zip 33136 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861996696 | Renuvala LLC | Prosthetic/Orthotic Supplier | 750 Nw 113 St, Miami, FL 33168 | 2018-03-19 |
| 1003327339 | All Orthopedic Supplies Corp | Prosthetic/Orthotic Supplier | 175 Fontainbleau Blvd, Ste P1, Miami, FL 33172 | 2017-10-13 |
| 1538573373 | Ponce Medical Supply Inc | Prosthetic/Orthotic Supplier | 5068 Nw 74 Ave, Miami, FL 33166 | 2014-06-19 |
| 1003230632 | Ortho Pro Associates, Inc. | Prosthetic/Orthotic Supplier | 2450 Ne Miami Gardens Dr, Suite 100, Miami, FL 33180-2717 | 2014-02-18 |
| 1427332212 | Girls In Pink Mastectomy Products | Prosthetic/Orthotic Supplier | 15894 Sw 85th Ln, Miami, FL 33193-5208 | 2011-09-28 |
| 1679800593 | Quirantes Orthopedics Rx | Prosthetic/Orthotic Supplier | 6969 Coral Way, Miami, FL 33155-1705 | 2009-11-13 |
| 1447413778 | Ladies In Pink Boutique LLC | Prosthetic/Orthotic Supplier | 271 Nw 82nd Ave, Miami, FL 33126-8339 | 2008-07-07 |
| 1104099845 | Ortho Care Rx Corp | Prosthetic/Orthotic Supplier | 1707 Coral Way, Miami, FL 33145-2728 | 2008-04-02 |
| 1295931210 | Rx Castillo Orthopedic Center, Inc | Prosthetic/Orthotic Supplier | 3183 Sw 8th St, Miami, FL 33135-4533 | 2007-06-26 |
| 1578699393 | Kendall Prosthetics & Orthotics, Inc. | Prosthetic/Orthotic Supplier | 13044 Sw 120th St, Miami, FL 33186-4522 | 2007-02-26 |
| Find all providers in MIAMI | ||||
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| 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.