Provider Demographics
NPI:1881021954
Name:USPHS
Entity Type:Organization
Organization Name:USPHS
Other - Org Name:KROME REFERRAL MEDICAL CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:HOSPITAL ADMINISTRATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:EUNICE
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES-WILLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-207-2121
Mailing Address - Street 1:18201 SW 12TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33194-2700
Mailing Address - Country:US
Mailing Address - Phone:305-207-5086
Mailing Address - Fax:
Practice Address - Street 1:18201 SW 12TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33194-2700
Practice Address - Country:US
Practice Address - Phone:305-207-5086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9107559261QP2400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2400XAmbulatory Health Care FacilitiesClinic/CenterPrison Health