Healthcare Provider Details

I. General information

NPI: 1518941806
Provider Name (Legal Business Name): MARINERS HOSPITAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2005
Last Update Date: 09/02/2025
Certification Date: 02/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91500 OVERSEAS HWY
TAVERNIER FL
33070-2547
US

IV. Provider business mailing address

6855 RED RD STE 600
CORAL GABLES FL
33143-3518
US

V. Phone/Fax

Practice location:
  • Phone: 305-434-3000
  • Fax:
Mailing address:
  • Phone: 786-662-7111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number4061
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number4061
License Number StateFL

VIII. Authorized Official

Name: MR. DREW GROSSMAN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 786-662-7111