Healthcare Provider Details

I. General information

NPI: 1639083827
Provider Name (Legal Business Name): JOHNS HOPKINS ALL CHILDREN'S HOSPITAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 HARBOR VILLAGE CARE CENTER
APOLLO BEACH FL
33572
US

IV. Provider business mailing address

501 6TH AVE S
SAINT PETERSBURG FL
33701-4634
US

V. Phone/Fax

Practice location:
  • Phone: 727-898-7451
  • Fax:
Mailing address:
  • Phone: 727-898-7451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: KELLY KINSLER
Title or Position: PROVIDER ENROLLMENT SUPERVISOR
Credential:
Phone: 727-767-3407