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General NPI Number Information
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NPI Number | 1932188125
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Entity Type | Organization
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Legal Business Name | SUMMIT HEALTH PLAN, INC.
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Dates
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Enumeration Date | 01/16/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 300 S PARK RD
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City | HOLLYWOOD
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State | FL
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Zip | 33021-8593
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Country | US
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Telephone | 954-962-3008
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Fax |
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Provider Business Mailing Address
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Address Line | 300 S PARK RD
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City | HOLLYWOOD
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State | FL
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Zip | 33021-8593
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Country | US
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Telephone | 954-962-3008
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT OF COMPLIANCE
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Name | MS. DARCEY A. GARTNER
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Credential | CHC
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Telephone | 954-965-3118
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 05-
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License Number State | FL
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