Healthcare Provider Details
I. General information
NPI: 1912916974
Provider Name (Legal Business Name): SACRED HEART HOSPITAL ER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/07/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5151 N 9TH AVE
PENSACOLA FL
32504-8721
US
IV. Provider business mailing address
5151 N 9TH AVE
PENSACOLA FL
32504-8721
US
V. Phone/Fax
- Phone: 850-416-6670
- Fax: 850-416-4694
- Phone: 850-416-6670
- Fax: 850-416-4694
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
GARY
M.
PABLO
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 850-416-6670