Healthcare Provider Details

I. General information

NPI: 1780080598
Provider Name (Legal Business Name): EAST COAST HOSPITALIST PHYSICIANS LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2014
Last Update Date: 11/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 NW 95TH ST
MIAMI FL
33150-2038
US

IV. Provider business mailing address

75 REMIT DR # 1103
CHICAGO IL
60675-0001
US

V. Phone/Fax

Practice location:
  • Phone: 305-835-6000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DERIK K KING
Title or Position: MANAGING PARTNER
Credential: M.D.
Phone: 866-916-5259