1073500419 NPI number — SOUTHWESTERN REGIONAL MEDICAL CENTER, LLC

Table of content: IRENE CARDENAS TRON LPC (NPI 1467167833)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073500419 NPI number — SOUTHWESTERN REGIONAL MEDICAL CENTER, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOUTHWESTERN REGIONAL MEDICAL CENTER, LLC
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:
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:
1073500419
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/17/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5900 BROKEN SOUND PKWY NW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BOCA RATON
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33487-2797
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
918-286-5000
Provider Business Mailing Address Fax Number:
918-286-5081

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10109 E 79TH STREET SOUTH
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TULSA
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74133
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
918-286-5000
Provider Business Practice Location Address Fax Number:
918-286-5081
Provider Enumeration Date:
09/30/2005

Additional Information

Authorized Official

Authorized Official Last Name:
HAYNIE
Authorized Official First Name:
DANA
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
918-286-5793

Provider Taxonomy Codes

  • Taxonomy code: 284300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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