1285681908 NPI number — CENTRAL FLORIDA REGIONAL HOSPITAL, INC

Table of content: MICHELE BAEDER DPT (NPI 1871962993)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285681908 NPI number — CENTRAL FLORIDA REGIONAL HOSPITAL, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTRAL FLORIDA REGIONAL 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:
1285681908
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/15/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1401 W SEMINOLE BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SANFORD
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32771-6737
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
407-321-4500
Provider Business Mailing Address Fax Number:
407-324-4790

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1401 W SEMINOLE BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANFORD
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32771-6737
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
407-321-4500
Provider Business Practice Location Address Fax Number:
407-324-4790
Provider Enumeration Date:
05/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BORING
Authorized Official First Name:
CHAD
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
407-302-7362

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: 228382 . This is a "AMERIGROUP" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 322 . This is a "BLUE CROSS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 10178800 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7029888 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000589245X , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 089001 . This is a "AVMED" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 01557262 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10650B , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010178800 . 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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