Healthcare Provider Details

I. General information

NPI: 1720019995
Provider Name (Legal Business Name): NORTH SHORE MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 03/15/2021
Certification Date: 03/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 NW 95TH ST
MIAMI FL
33150-2038
US

IV. Provider business mailing address

PO BOX 740926
ATLANTA GA
30374-0926
US

V. Phone/Fax

Practice location:
  • Phone: 305-835-6000
  • Fax:
Mailing address:
  • Phone: 561-982-2189
  • Fax: 305-835-6163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number4133
License Number StateFL

VIII. Authorized Official

Name: MR. CRAIG C. ARMIN
Title or Position: VP OF GOVT PROGRAMS, TENET
Credential:
Phone: 818-436-2267