Healthcare Provider Details

I. General information

NPI: 1821553710
Provider Name (Legal Business Name): FLORIDA HOSPITAL DADE CITY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2019
Last Update Date: 06/25/2024
Certification Date: 06/25/2024
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: 352-521-1100
  • Fax:
Mailing address:
  • Phone: 352-521-1100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: RYAN WILLIS
Title or Position: CFO
Credential:
Phone: 813-615-7097