1063442770 NPI number — HIALEAH HOSPITAL INC.

Table of content: (NPI 1063442770)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063442770 NPI number — HIALEAH HOSPITAL INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HIALEAH HOSPITAL INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1063442770
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/16/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 740922
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30374-0922
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-982-2189
Provider Business Mailing Address Fax Number:
305-835-4252

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
651 E 25TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HIALEAH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33013-3814
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-693-6100
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ARMIN
Authorized Official First Name:
CRAIG
Authorized Official Middle Name:
C
Authorized Official Title or Position:
VP OF GOVT PROGRAMS, TENET
Authorized Official Telephone Number:
818-436-2267

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  4347 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 223387 . This is a "AVMED" identifier . This identifiers is of the category "OTHER".
  • Identifier: 010041200 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 990111 . This is a "NEIGHBORHOOD HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 788724700 . This is a "AETNA US HEALTHCARE (NATI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 232 . This is a "BCBS OF FLORIDA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 080091 . This is a "HUMANA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 100053B000000 . This is a "SECTION 1011" identifier . This identifiers is of the category "OTHER".




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