OrganizationActiveAccepts Medicare
Public Health Trust of Miami Dade County Florida
NPI 1730767971 · Community/Retail Pharmacy · Doral, FL
Enrolled with Medicare as Dme Supplier - Pharmacy · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1730767971
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Mark Knight, Evp Cfo(305) 585-7979
Specialties & taxonomies
Suppliers
Profile Score
Established profile(62/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2801 Nw 79th Ave
Doral, FL 33122-1174
Phone: (786) 466-1010
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 12493
Miami, FL 33101-2493
Other names (DBA / former)
- Doing business as
- Jackson Pharmacy -West -52081
Registry dates
- Enumerated
- 2021-03-30
- Last updated
- 2021-03-30
- Certified
- 2021-03-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.