| Contacts | Authorizing Official | Update | Profile Change Request | Doblecki-Lewis, Susanne
Professor of Clinical Medicine and Director, Division of Infectious Diseases
University of Miami
3052437652 | Doblecki-Lewis, Susanne
Professor of Clinical Medicine and Chief, Division of Infectious Diseases
University of Miami
3052437652 | 8/26/2024 10:23 AM |
| Contacts | Signed By | Update | Profile Change Request | Doblecki-Lewis, Susanne
Professor of Clinical Medicine and Director, Division of Infectious Diseases
University of Miami
3052437652 | Doblecki-Lewis, Susanne
Professor of Clinical Medicine and Chief, Division of Infectious Diseases
University of Miami
3052437652 | 8/26/2024 10:23 AM |
| Contacts | Authorizing Official | Update | Profile Change Request | Doblecki-Lewis, Susanne
Professor of Clinical Medicine and Director, Division of Infectious Diseases
University of Miami
3052439213 | Doblecki-Lewis, Susanne
Professor of Clinical Medicine and Director, Division of Infectious Diseases
University of Miami
3052437652 | 8/2/2024 6:27 AM |
| Contacts | Signed By | Update | Profile Change Request | Doblecki-Lewis, Susanne
Professor of Clinical Medicine and Director, Division of Infectious Diseases
University of Miami
3052439213 | Doblecki-Lewis, Susanne
Professor of Clinical Medicine and Director, Division of Infectious Diseases
University of Miami
3052437652 | 8/2/2024 6:27 AM |
| Contacts | Primary Contact | Update | Profile Change Request | Narcisse, Gilianne
Clinical Pharmacist
University of Miami
3052432584 | Narcisse, Gilianne
Pharmacist
University of Miami
3052432584 | 7/24/2024 12:01 PM |
| Contacts | Authorizing Official | Update | Profile Change Request | Doblecki-Lewis, Susanne
Associate Professor of Clinical Medicine and Clinical Director of Division of Infectious Diseases
University of Miami
3052439213 | Doblecki-Lewis, Susanne
Professor of Clinical Medicine and Director, Division of Infectious Diseases
University of Miami
3052439213 | 4/1/2024 3:23 PM |
| Contacts | Signed By | Update | Profile Change Request | Doblecki-Lewis, Susanne
Associate Professor of Clinical Medicine and Clinical Director of Division of Infectious Diseases
University of Miami
3052439213 | Doblecki-Lewis, Susanne
Professor of Clinical Medicine and Director, Division of Infectious Diseases
University of Miami
3052439213 | 4/1/2024 3:23 PM |
| Details | State | Update | | To Be Terminated | Terminated | 10/1/2020 12:01 AM |
| Dates | Last Date That 340B Drugs Purchased | Update | Termination Request | | 7/15/2020 12:00:00 AM | 7/21/2020 7:00 PM |
| Details | State | Update | Termination Request | Active | To Be Terminated | 7/21/2020 7:00 PM |
| Terminations | Termination Date | Update | Termination Request | | 10/1/2020 12:00:00 AM | 7/21/2020 7:00 PM |
| Terminations | Termination Effective Date | Update | Termination Request | | 7/15/2020 12:00:00 AM | 7/21/2020 7:00 PM |
| Terminations | Termination Reason | Update | Termination Request | | Business decision by the Covered Entity | 7/21/2020 7:00 PM |
| Details | Last Recertification Date | Update | Recertification | 5/22/2019 9:31:02 AM | 5/24/2020 5:57:01 PM | 5/24/2020 5:57 PM |
| Addresses | Main Address | Update | Change Request |
1800 NW 10th ave
Miami, FL 33136 |
1951 NW 7th avenue
Miami, FL 33136 | 2/14/2020 7:25 AM |
| Details | Last Recertification Date | Update | Recertification | | 5/22/2019 9:31:02 AM | 5/22/2019 9:31 AM |
| Details | Grant Number | Update | Recertification | 5H25PS004342 | NH25PS005131 | 5/22/2019 9:31 AM |
| Contacts | Primary Contact | Update | Profile Change Request | Narcisse, Gilianne
Clinical Pharmacist
University of Miami
3052433458 | Narcisse, Gilianne
Clinical Pharmacist
University of Miami
3052432584 | 5/17/2019 8:48 AM |
| Contacts | Primary Contact | Update | Recertification | Narcisse, Gilianne
Clinical Pharmacist
University of Miami
3052432584 | Narcisse, Gilianne
Clinical Pharmacist
University of Miami
3052433458 | 5/17/2019 8:47 AM |
| Contacts | Primary Contact | Update | Profile Change Request | Narcisse, Gilianne
Clinical Pharmacist
University of Miami
3052433458 | Narcisse, Gilianne
Clinical Pharmacist
University of Miami
3052432584 | 5/17/2019 8:46 AM |
| Details | State | Update | | Approved | Active | 10/1/2018 12:05 AM |
| Contacts | Signed By | Insert | New Registration | | Doblecki-Lewis, Susanne
Associate Professor of Clinical Medicine and Clinical Director of Division of Infectious Diseases
University of Miami
3052439213 | 8/17/2018 3:50 PM |
| Details | 340B ID | Update | New Registration | | STD331363 | 8/17/2018 3:50 PM |
| Dates | Participating Approval Date | Update | New Registration | | 8/17/2018 3:50:22 PM | 8/17/2018 3:50 PM |
| Details | State | Update | New Registration | Pending | Approved | 8/17/2018 3:50 PM |
| Dates | Signed By Date | Update | New Registration | | 7/14/2018 10:42:06 AM | 8/17/2018 3:50 PM |
| Dates | Start Date | Update | New Registration | | 10/1/2018 12:00:00 AM | 8/17/2018 3:50 PM |
| Addresses | Main Address | Insert | New Registration | |
1800 NW 10th ave
Miami, FL 33136 | 7/12/2018 9:13 AM |
| Details | Nature Of Support | Insert | New Registration | | In-Kind products or services (see note below; must have been purchased with section 318 funds) | 7/12/2018 9:13 AM |
| Contacts | Primary Contact | Insert | New Registration | | Narcisse, Gilianne
Clinical Pharmacist
University of Miami
3052433458 | 7/12/2018 9:13 AM |
| Contacts | Authorizing Official | Insert | New Registration | | Doblecki-Lewis, Susanne
Associate Professor of Clinical Medicine and Clinical Director of Division of Infectious Diseases
University of Miami
3052439213 | 7/12/2018 9:13 AM |
| Details | Last Recertification Date | Insert | New Registration | | | 7/12/2018 9:13 AM |
| Details | Grant Number | Insert | New Registration | | 5H25PS004342 | 7/12/2018 9:13 AM |
| Details | 340B ID | Insert | New Registration | | | 7/12/2018 9:13 AM |
| Details | Is Authorizing Official EHB Data | Insert | New Registration | | | 7/12/2018 9:13 AM |
| Dates | Last Date That 340B Drugs Purchased | Insert | New Registration | | | 7/12/2018 9:13 AM |
| Details | Medicare Provider Number | Insert | New Registration | | | 7/12/2018 9:13 AM |
| Details | Entity Name | Insert | New Registration | | University of Miami PrEP Clinic | 7/12/2018 9:13 AM |
| Details | Program Code | Insert | New Registration | | STD | 7/12/2018 9:13 AM |
| Details | Entity Subname | Insert | New Registration | | | 7/12/2018 9:13 AM |
| Dates | Participating Approval Date | Insert | New Registration | | | 7/12/2018 9:13 AM |
| Details | State | Insert | New Registration | | Pending | 7/12/2018 9:13 AM |
| Dates | Registration Date | Insert | New Registration | | 7/12/2018 9:13:08 AM | 7/12/2018 9:13 AM |
| Dates | Signed By Date | Insert | New Registration | | | 7/12/2018 9:13 AM |
| Dates | Start Date | Insert | New Registration | | | 7/12/2018 9:13 AM |
| Terminations | Termination Comments | Insert | New Registration | | | 7/12/2018 9:13 AM |
| Terminations | Termination Date | Insert | New Registration | | | 7/12/2018 9:13 AM |
| Terminations | Termination Effective Date | Insert | New Registration | | | 7/12/2018 9:13 AM |
| Terminations | Termination Reason | Insert | New Registration | | | 7/12/2018 9:13 AM |