Healthcare Provider Details

I. General information

NPI: 1578547865
Provider Name (Legal Business Name): HOMESTEAD HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2005
Last Update Date: 09/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 BAPTIST WAY
HOMESTEAD FL
33033-7600
US

IV. Provider business mailing address

6855 RED RD STE 500
CORAL GABLES FL
33143-3632
US

V. Phone/Fax

Practice location:
  • Phone: 786-243-8000
  • Fax:
Mailing address:
  • Phone:
  • Fax: 786-533-9403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number4486
License Number StateFL

VIII. Authorized Official

Name: KENNETH SPELL
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 786-662-7111