Provider Demographics
NPI:1821093451
Name:MIAMI JEWISH HEALTH SYSTEMS, INC.
Entity Type:Organization
Organization Name:MIAMI JEWISH HEALTH SYSTEMS, INC.
Other - Org Name:MIAMI JEWISH HOME & HOSPITAL FOR THE AGED, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:NURSING HOME ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:PINCUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-751-8626
Mailing Address - Street 1:5200 NE 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137
Mailing Address - Country:US
Mailing Address - Phone:305-751-8626
Mailing Address - Fax:305-762-1431
Practice Address - Street 1:5200 NE 2ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137
Practice Address - Country:US
Practice Address - Phone:305-751-8626
Practice Address - Fax:305-762-1431
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MIAMI JEWISH HEALTH SYSTEMS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-06-20
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11354314000000X
FL0633620001332BN1400X, 332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL020050600Medicaid
FL000277Medicare Oscar/Certification
FL0633620001Medicare NSC
FL105030Medicare Oscar/Certification