MEDICARE: MORTON PLANT HOSPITAL ASSOCIATION INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	273R00000X	Psychiatric Hospital Unit	4064	FL
2	282N00000X	General Acute Care Hospital	4064	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	10D0645549	OTHER	FL	CLIA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376529743
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MORTON PLANT HOSPITAL ASSOCIATION INC

Provider Business Mailing Address
First Line	:	300 PINELLAS ST
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33756-3804
Country	:	US
Telephone Number	:	727-281-9479
Fax Number	:	727-461-8101

Provider Business Practice Location Address
First Line	:	300 PINELLAS ST
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33756-3804
Country	:	US
Telephone Number	:	727-462-7000
Fax Number	:	727-461-8101

Authorized Official
Title or Position	:	DIRECTOR, REVENUE MANAGEMENT SVS
Name	:	MR. BRIANT KEEN
Credential	:
Telephone Number	:	727-519-1672

Provider Enumeration Date	:	12/19/2005
Last Update Date	:	03/07/2023

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