Healthcare Provider Details

I. General information

NPI: 1558032086
Provider Name (Legal Business Name): BETHESDA HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2021
Last Update Date: 04/24/2023
Certification Date: 04/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9655 BOYNTON BEACH BLVD
BOYNTON BEACH FL
33472-4421
US

IV. Provider business mailing address

6855 S RED RD STE 600
SOUTH MIAMI FL
33143-3518
US

V. Phone/Fax

Practice location:
  • Phone: 561-336-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: JARED SMITH
Title or Position: CEO
Credential:
Phone: 786-662-7111