MEDICARE: SOUTH FLORIDA BAPTIST HOSPITAL 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	207V00000X	Obstetrics & Gynecology Physician

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

General Provider Information

NPI Number	:	1598056467
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH FLORIDA BAPTIST HOSPITAL INC.

Provider Business Mailing Address
First Line	:	2995 DREW ST FL 2
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33759-3012
Country	:	US
Telephone Number	:	727-315-6974
Fax Number	:	813-635-2613

Provider Business Practice Location Address
First Line	:	1603 W REYNOLDS ST
Second Line	:
City	:	PLANT CITY
State	:	FL
Zip	:	33563-4735
Country	:	US
Telephone Number	:	813-852-3272
Fax Number	:	813-635-2613

Authorized Official
Title or Position	:	CFO
Name	:	MS. CATHY YODER
Credential	:
Telephone Number	:	813-870-4235

Provider Enumeration Date	:	04/27/2011
Last Update Date	:	05/31/2024

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