=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043523210
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HCA HEALTH SERVICES OF FLORIDA, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/16/2010
-----------------------------------------------------
Last Update Date | 04/24/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1800 SE TIFFANY AVE
-----------------------------------------------------
City | PORT ST LUCIE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34952-7521
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 772-335-4000
-----------------------------------------------------
Fax | 561-398-3608
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1800 SE TIFFANY AVE
-----------------------------------------------------
City | PORT ST LUCIE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34952-7521
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 772-335-4000
-----------------------------------------------------
Fax | 561-398-3608
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CFO
-----------------------------------------------------
Name | NICOLE GARLINGHOUSE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 772-335-4000
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 273R00000X
-----------------------------------------------------
Taxonomy Name | Psychiatric Hospital Unit
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------