JACKSON MEDICAL GROUP – NPI #1326780016
General Practice

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

JACKSON MEDICAL GROUP is a provider located in MIAMI, FL. NPPES has assigned the NPI number 1326780016 to JACKSON MEDICAL GROUP on April 12, 2022. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “JACKSON MEDICAL GROUP” is a dba name, the actual legal business name for this organization is PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY FLORIDA. The primary taxonomy selected by this provider is 208D00000X from the Health Care Provider Taxonomy code set, which is classified as General Practice.

The NPI profile was previously updated about 2 years ago on Jan 17, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for JACKSON MEDICAL GROUP below.

NPI Profile for
PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY FLORIDA

NPI Number
1326780016
Enumeration Date

(more than 4 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY FLORIDA
Doing Business As (dba): JACKSON MEDICAL GROUP
Primary location
1502 NW 4 STREET
RETAIL NO. 5
MIAMI, FL 33125
Phone: (305) 585-3701 Fax:
Mailing address
PO BOX 12493
MIAMI, FL 33101-2493
Phone: (786) 466-8101 Fax:
Organization Subpart
Yes - JACKSON MEDICAL GROUP is subpart of another organization.
Authorized Official
MARK KNIGHT
EVP CFO
Phone: (305) 585-4211
Updated
Certification Date
Jan 17, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
208D00000X
- General Practice (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.