Healthcare Provider Details

I. General information

NPI: 1356336069
Provider Name (Legal Business Name): PASCO REGIONAL MEDICAL CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2005
Last Update Date: 02/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13100 FORT KING RD
DADE CITY FL
33525-5294
US

IV. Provider business mailing address

13100 FORT KING RD
DADE CITY FL
33525-5294
US

V. Phone/Fax

Practice location:
  • Phone: 352-521-1000
  • Fax: 352-521-4028
Mailing address:
  • Phone: 352-521-1000
  • Fax: 352-521-4028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: PAULA LALOR
Title or Position: DIRECTOR/DELEGATED OFFICIAL
Credential:
Phone: 615-925-4565