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General NPI Number Information
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NPI Number | 1841109808
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Entity Type | Organization
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Legal Business Name | FLORIDA HOSPITAL WATERMAN INC
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Dates
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Enumeration Date | 09/04/2026
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Last Update Date | 09/04/2026
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Provider Practice Location Address
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Address Line | 201 COUNTY RD 466A
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City | FRUITLAND PARK
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State | FL
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Zip | 34731-5153
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Country | US
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Telephone | 352-508-4235
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Fax |
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Provider Business Mailing Address
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Address Line | 770 W GRANADA BLVD STE 203
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City | ORMOND BEACH
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State | FL
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Zip | 32174-5179
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | ANDRII KORCHUK
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Credential |
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Telephone | 352-253-3300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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