OrganizationPublic Health Trust Of Dade County Florida(<Unavail>)Internal MedicineAllopathic & Osteopathic PhysiciansPractice Address1611 NW 12th Avenue, Miami, FL 33136(305) 585-8957PECOS EnrollmentBased on the most recent information from CMS, provider Public Health Trust Of Dade County Florida 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 yesterday at 12:57 PM.Profile DetailsProvider ID1124062542Provider TypeOrganizationFull NamePublic Health Trust Of Dade County FloridaOther Name<Unavail>SubpartYesEnumeration Date6/15/2006Last Updated6/19/2008Contact InformationPractice LocationPractice Address1611 NW 12th Avenue, Miami, FL 33136Phone(305) 585-8957Fax(305) 585-5259Mailing LocationMailing AddressPO Box 918757, Orlando, FL 32891-8757Phone(305) 585-8957Fax(305) 585-5259Authorized OfficialNameBarrett, Frank J. (Exec. Vp, Chief Financial Officer)Phone(305) 585-7137Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense3998FloridaCode207L00000XDescriptionAnesthesiologyAllopathic & Osteopathic PhysiciansLicense3998FloridaCode207Q00000XDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense3998FloridaProvider IdentifiersIDDescriptionIssuerID010042111DescriptionMedicaidIssuerUnlistedFlorida