JACKSON MEMORIAL HOSPITAL (NPI# 1861603706) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861603706 |
| Entity Type | Organization |
| Organization Name | JACKSON MEMORIAL HOSPITAL |
| Practice Address |
1600 Nw 12th Ave. Suite C-150 Miami FL 33136 |
| Mailing Address |
7634 S.w. 106 Ave. Miami FL 33173 |
| Practice Telephone | 3055851520 |
| Practice Fax Number | 3055851551 |
| Mailing Telephone | 3057425717 |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. CHARLES LYNNE (MD- DEPARTMENT OF UROLOGY) |
| Authorized Official Telephone | 3055851520 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 261Q00000X | Clinic/Center | 1646212 | FL | Ambulatory Health Care Facilities |
| X | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
1646212 | FL | Hospitals |
| 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 |
| 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 |
| 1366973745 | Jackson Memorial Hospital | Skilled Nursing Facility | 1611 Nw 12th Ave, East Tower, Miami, FL 33136-1005 | 2017-03-27 |
| 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 |
| Street Address |
1600 NW 12TH AVE. SUITE C-150 |
| City | MIAMI |
| State | FL |
| Zip Code | 33136 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154503001 | University of Miami | Speech-Language Pathologist | 1600 Nw 12th Ave., Miami, FL 33136 | 2007-12-03 |
| 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 | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
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| 1386242055 | A & P Therapy Services, LLC | Clinic/Center | 2061 Sw 150th Ave, Miami, FL 33185-5689 | 2020-10-14 |
| 1598371064 | Orive Physician Services Pa | Clinic/Center | 7235 Sw 39th St, Miami, FL 33155-6615 | 2020-09-21 |
| 1174139745 | The Fidelity Health Care Group Florida, LLC | Clinic/Center | 1065 Sw 8th St Unit 135, Miami, FL 33130-3601 | 2020-09-19 |
| 1972117224 | Beautiful Minds Medical Center LLC | Clinic/Center | 11045 Sw 216th Street, Unit 6, Miami, FL 33170 | 2020-09-03 |
| 1912510751 | Abc Health Care Services LLC | Clinic/Center | 175 Fontainebleau Blvd # 2a2, Miami, FL 33172-7018 | 2020-08-30 |
| 1952914517 | Therapy Unlimited Miami | Clinic/Center | 792 Nw 123rd Ct, Miami, FL 33182-2429 | 2020-08-24 |
| 1801405170 | Blue Medical Center Corp | Clinic/Center | 7805 Sw 24th St Ste 129, Miami, FL 33155-6553 | 2020-07-23 |
| 1407473820 | Caremax Medical Center of Westchester, L.L.C. | Clinic/Center | 8755 Sw 24th St, Miami, FL 33165-2005 | 2020-07-01 |
| 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.