Healthcare Provider Details

I. General information

NPI: 1003908443
Provider Name (Legal Business Name): MERCY HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3663 SOUTH MIAMI AVENUE
MIAMI FL
33133
US

IV. Provider business mailing address

3663 SOUTH MIAMI AVENUE
MIAMI FL
33133
US

V. Phone/Fax

Practice location:
  • Phone: 305-860-5239
  • Fax: 305-860-4668
Mailing address:
  • Phone: 305-860-5239
  • Fax: 305-860-4668

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. JOHN E MATUSKA
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: CEO
Phone: 305-854-4400