Provider Demographics
NPI:1982260840
Name:ST. JOSEPH HEALTHCARE SYSTEM CORP
Entity Type:Organization
Organization Name:ST. JOSEPH HEALTHCARE SYSTEM CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUANA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-922-0331
Mailing Address - Street 1:15476 NW 77TH CT STE 1012
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5823
Mailing Address - Country:US
Mailing Address - Phone:305-981-6373
Mailing Address - Fax:
Practice Address - Street 1:8415 NW 170TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-3713
Practice Address - Country:US
Practice Address - Phone:305-981-6373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-16
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health