1144274879 NPI number — LARGO MEDICAL CENTER, INC.

Table of content: (NPI 1144274879)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144274879 NPI number — LARGO MEDICAL CENTER, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LARGO MEDICAL CENTER, 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:
1144274879
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/30/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11315 CORPORATE BLVD
Provider Second Line Business Mailing Address:
SUITE 310
Provider Business Mailing Address City Name:
ORLANDO
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32817-8344
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-588-5800
Provider Business Mailing Address Fax Number:
727-588-5906

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
201 14TH ST SW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LARGO
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33770-3133
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-588-5800
Provider Business Practice Location Address Fax Number:
727-588-5906
Provider Enumeration Date:
05/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ROMIG
Authorized Official First Name:
GLENN
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
727-588-5251

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 185270000 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 011974100 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1782131 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2848144 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 404862785 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1003151 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000231679X , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 030982500 . This is a "BLACK LUNG" identifier . This identifiers is of the category "OTHER".
  • Identifier: 304862847 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: HOS0248N , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000030936 . This is a "HUMANA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 11301B , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 20211 . This is a "WELLCARE/STAYWELL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00807254 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0683907 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 576 . This is a "BLUE CROSS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 0068893 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: HO00712 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 011974100 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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