Healthcare Provider Details

I. General information

NPI: 1265469605
Provider Name (Legal Business Name): FMC HOSPITAL, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 03/16/2021
Certification Date: 03/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 W OAKLAND PARK BLVD
LAUDERDALE LAKES FL
33313-1503
US

IV. Provider business mailing address

PO BOX 740944
ATLANTA GA
30374-0944
US

V. Phone/Fax

Practice location:
  • Phone: 954-735-6000
  • Fax:
Mailing address:
  • Phone: 561-982-2189
  • Fax: 954-735-0532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number4207
License Number StateFL

VIII. Authorized Official

Name: MR. CRAIG C. ARMIN
Title or Position: VP OF GOVT PROGRAMS, TENET
Credential:
Phone: 818-436-2267