Healthcare Provider Details

I. General information

NPI: 1427002070
Provider Name (Legal Business Name): ATLANTIC SHORES HOSPITAL L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 04/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4545 NORTH FEDERAL HIGHWAY
FT LAUDERDALE FL
33068
US

IV. Provider business mailing address

4545 NORTH FEDERAL HIGHWAY
FT LAUDERDALE FL
33068
US

V. Phone/Fax

Practice location:
  • Phone: 954-771-2711
  • Fax: 954-493-9998
Mailing address:
  • Phone: 954-771-2711
  • Fax: 954-493-9998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number4045
License Number StateFL

VIII. Authorized Official

Name: STEVE FILLTON
Title or Position: SR VP CFO
Credential:
Phone: 610-768-3300