Healthcare Provider Details

I. General information

NPI: 1578956744
Provider Name (Legal Business Name): EAST COAST HOSPITALIST PHYSICIANS LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2015
Last Update Date: 03/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 NW 12TH AVE
MIAMI FL
33136-1003
US

IV. Provider business mailing address

75 REMIT DR # 1367
CHICAGO IL
60675-1367
US

V. Phone/Fax

Practice location:
  • Phone: 305-325-5511
  • Fax: 305-325-4673
Mailing address:
  • Phone: 855-332-4499
  • Fax: 231-932-4133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. DERIK K KING
Title or Position: MANAGING PARTNER
Credential: MD
Phone: 800-701-3381