Organization

Pmc Jackson South, Llc

Clinic/Center in Miami, FL(View on Map)

Legal Business Name

Pmc Jackson South, Llc

NPI Number

1043469232

NPI Type

Organization

Enumeration Date

09/12/2008

Specialties

(Taxonomies)

Code

261Q00000X

Primary Taxonomy

Yes

Contact
Information

Purpose

Mailing
Location

Address

12550 BISCAYNE BLVD STE 500
9380 SW 150TH ST STE 100

City

North Miami
Miami

State

FL
FL

Postal Code

33181-2544
33176-7979

Country

US
US

Telephone Number

(305) 868-7180
(305) 253-2665

Authorized Official

Name

Mr. Spencer Angel

Title or Position

MNG MBR

Telephone Number

(305) 868-7180

Identifiers

Identifier

207R00000X

Identifier State

FL

Identifier Issuer

TAXONOMY

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 09/12/2008

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