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General NPI Number Information
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NPI Number | 1578547865
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Entity Type | Organization
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Legal Business Name | HOMESTEAD HOSPITAL INC
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Dates
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Enumeration Date | 12/01/2005
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Last Update Date | 09/24/2019
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Provider Practice Location Address
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Address Line | 975 BAPTIST WAY
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City | HOMESTEAD
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State | FL
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Zip | 33033-7600
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Country | US
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Telephone | 786-243-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 6855 RED RD STE 500
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City | CORAL GABLES
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State | FL
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Zip | 33143-3632
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Country | US
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Telephone |
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Fax | 786-533-9403
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | KENNETH SPELL
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Credential |
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Telephone | 786-662-7111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273Y00000X
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Taxonomy Name | Rehabilitation Hospital Unit
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 4486
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License Number State | FL
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