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: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 HARBOR VILLAGE CARE CENTER
APOLLO BEACH FL
33572
US

IV. Provider business mailing address

211 HARBOR VILLAGE CARE CENTER
APOLLO BEACH FL
33572
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