OrganizationJackson Memorial HospitalGeneral Acute Care HospitalHospitalsPractice Address1611 NW 12th Ave, Miami, FL 33136-1005(305) 585-5513(305) 798-0272PECOS EnrollmentBased on the most recent information from CMS, provider Jackson Memorial Hospital does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 15 days ago.Profile DetailsProvider ID1013959972Provider TypeOrganizationFull NameJackson Memorial HospitalSubpartNoEnumeration Date6/12/2006Last Updated2/10/2010Contact InformationPractice LocationPractice Address1611 NW 12th Ave, Miami, FL 33136-1005Phone(305) 585-5513FaxUnlisted FaxMailing LocationMailing Address759 NW 174th Ave, Pembroke Pines, FL 33029-3145Phone(305) 798-0272FaxUnlisted FaxAuthorized OfficialNameCespedes, Roxanne (Director Care-A-Van)Phone(305) 585-5513Provider TaxonomiesCodeDescriptionLicenseCode282N00000XPrimaryDescriptionGeneral Acute Care HospitalHospitalsLicense1735652FloridaProvider IdentifiersIDDescriptionIssuerID1477629145.DescriptionOtherIssuerNPIFlorida