Healthcare Provider Details

I. General information

NPI: 1700919768
Provider Name (Legal Business Name): LARKIN COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 03/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7031 SW 62ND AVENUE
MIAMI FL
33143
US

IV. Provider business mailing address

7031 SW 62ND AVENUE
MIAMI FL
33143
US

V. Phone/Fax

Practice location:
  • Phone: 305-284-7585
  • Fax:
Mailing address:
  • Phone: 305-284-7585
  • Fax: 305-284-7589

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number4288
License Number StateFL

VIII. Authorized Official

Name: MR. JACK MICHEL
Title or Position: CEO
Credential: MD
Phone: 305-284-7700