Healthcare Provider Details

I. General information

NPI: 1831530385
Provider Name (Legal Business Name): FLORIDIAN HOSPITALIST SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2013
Last Update Date: 07/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 N WICKHAM RD
MELBOURNE FL
32935-8625
US

IV. Provider business mailing address

5665 NEW NORTHSIDE DR SUITE 320
ATLANTA GA
30328-5831
US

V. Phone/Fax

Practice location:
  • Phone: 321-752-1200
  • Fax: 770-874-5483
Mailing address:
  • Phone: 770-874-5400
  • Fax: 770-874-5483

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. ROGER PAUL MURRAY
Title or Position: COO
Credential:
Phone: 770-874-5400