OrganizationJackson Memorial HospitalGeneral Acute Care HospitalHospitalsPractice Address1611 NW 12th Ave, Miami, FL 33136-1005(305) 585-1111(954) 322-1196PECOS 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 ID1376567727Provider TypeOrganizationFull NameJackson Memorial HospitalSubpartNoEnumeration Date7/27/2006Last Updated6/25/2008Contact InformationPractice LocationPractice Address1611 NW 12th Ave, Miami, FL 33136-1005Phone(305) 585-1111Fax(305) 585-0080Mailing LocationMailing Address19421 SW 30th St, Miramar, FL 33029-5808Phone(954) 322-1196Fax(954) 322-1510Authorized OfficialNameCaress, Amy (Nurse Practitioner)Phone(305) 585-1111Provider TaxonomiesCodeDescriptionLicenseCode282N00000XPrimaryDescriptionGeneral Acute Care HospitalHospitalsLicense1610072Florida