Jackson Mem Hos | Miami, FL • PECOS Search

Jackson Mem Hos

General Acute Care Hospital

Hospitals

1611 NW 12th Ave, Miami, FL 33136-1005

(305) 585-6677 (561) 968-5169

PECOS Enrollment

Based on the most recent information from CMS, provider Jackson Mem Hos does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 15 days ago.

Profile Details

Provider ID
1093869794
Provider Type
Organization
Full Name
Jackson Mem Hos

Subpart
No
Enumeration Date
1/22/2007
Last Updated
8/22/2020

Contact Information

Practice Location

1611 NW 12th Ave, Miami, FL 33136-1005

Unlisted Fax

Mailing Location

10429 Oak Meadow Ln, Lake Worth, FL 33467-5470

Unlisted Fax

Authorized Official

Roberts, Audrey Vivienne (Arnp)

Provider Taxonomies

Code	Description	License
Code 282N00000X Primary	Description General Acute Care Hospital Hospitals	License Unlisted Issuer