1982688230 NPI number — SOUTH MIAMI HOSPITAL INC

Table of content: (NPI 1982688230)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982688230 NPI number — SOUTH MIAMI HOSPITAL INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOUTH MIAMI 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:
1982688230
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/24/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6855 RED RD
Provider Second Line Business Mailing Address:
STE 500
Provider Business Mailing Address City Name:
CORAL GABLES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33143-3623
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
786-662-7980
Provider Business Mailing Address Fax Number:
786-533-9403

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6200 SW 73RD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOUTH MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33143-4679
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
786-662-4000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/30/2005

Additional Information

Authorized Official

Authorized Official Last Name:
DUQUETTE
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
786-662-7111

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  4033 , 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: 673316 . This is a "AETNA HMO" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 94530 . This is a "AMERIGROUP" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 1507 . This is a "MEDICA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 244 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 438155 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 010058700 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6201215 . This is a "AETNA NON HMO" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: SMIAMI1000 . This is a "NEIGHBORHOOD HEALTH" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 101684 . This is a "AVMED" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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