1821109612 NPI number — CITY OF MIAMI

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821109612 NPI number — CITY OF MIAMI

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF MIAMI
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821109612
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/16/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 947212
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30394-7212
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-416-5400
Provider Business Mailing Address Fax Number:
305-416-5444

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1151 NW 7TH ST
Provider Second Line Business Practice Location Address:
3RD FLOOR
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33136-3604
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-416-5400
Provider Business Practice Location Address Fax Number:
305-416-5444
Provider Enumeration Date:
08/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DIAZ
Authorized Official First Name:
CHRISTOPHER
Authorized Official Middle Name:
ALBERT
Authorized Official Title or Position:
ASSISTANT FIRE CHIEF
Authorized Official Telephone Number:
305-569-4008

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  1315 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 087475200 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 590003817 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: A0577 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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