Healthcare Provider Details

I. General information

NPI: 1285776765
Provider Name (Legal Business Name): MERCY HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 04/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3661 S MIAMI AVE SUITE 110
MIAMI FL
33133-4236
US

IV. Provider business mailing address

3661 S MIAMI AVE SUITE 110
MIAMI FL
33133-4236
US

V. Phone/Fax

Practice location:
  • Phone: 305-285-2762
  • Fax: 305-285-2606
Mailing address:
  • Phone: 305-285-2762
  • Fax: 305-285-2606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberPH6824
License Number StateFL

VIII. Authorized Official

Name: JOHN JOHNSON
Title or Position: CEO
Credential:
Phone: 305-854-4400