Healthcare Provider Details

I. General information

NPI: 1407921455
Provider Name (Legal Business Name): HOSPITAL OF SOUTH BEACH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 ALTON RD
MIAMI BEACH FL
33139-5502
US

IV. Provider business mailing address

2026 W UNIVERSITY DR
DENTON TX
76201-0644
US

V. Phone/Fax

Practice location:
  • Phone: 305-538-9418
  • Fax: 305-598-9418
Mailing address:
  • Phone: 940-320-8100
  • Fax: 940-320-0402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. THOMAS EDWARD ROURKE
Title or Position: CHIEF EXECUTIVE OFFICER, VP
Credential: LCSW
Phone: 940-320-8100