Healthcare Provider Details

I. General information

NPI: 1851346787
Provider Name (Legal Business Name): FISHERMEN'S HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 05/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 OVERSEAS HWY
MARATHON FL
33050-2329
US

IV. Provider business mailing address

3301 OVERSEAS HWY
MARATHON FL
33050-2329
US

V. Phone/Fax

Practice location:
  • Phone: 305-289-6401
  • Fax: 305-743-3962
Mailing address:
  • Phone: 305-289-6401
  • Fax: 305-743-3962

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number4389
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number4389
License Number StateFL

VIII. Authorized Official

Name: DR. HAL W LEFTWICH
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: DBA, FACHE
Phone: 305-289-6401