Provider Demographics
NPI:1831340900
Name:PUBLIC HEALTH TRUST OF DADE COUNTY FLORIDA
Entity type:Organization
Organization Name:PUBLIC HEALTH TRUST OF DADE COUNTY FLORIDA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MELIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:AKITI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:786-466-2710
Mailing Address - Street 1:20201 NW 37TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33056-1755
Mailing Address - Country:US
Mailing Address - Phone:786-466-2700
Mailing Address - Fax:786-466-2748
Practice Address - Street 1:20201 NW 37TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33056-1755
Practice Address - Country:US
Practice Address - Phone:786-466-2700
Practice Address - Fax:786-466-2748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-07
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL142202200Medicaid
FL99642Medicare PIN