Provider Demographics
NPI:1194744672
Name:LIFEMARK HOSPITALS OF FLORIDA, INC.
Entity type:Organization
Organization Name:LIFEMARK HOSPITALS OF FLORIDA, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP OF GOVT PROGRAMS, TENET
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:C
Authorized Official - Last Name:ARMIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-436-2267
Mailing Address - Street 1:PO BOX 740763
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-0763
Mailing Address - Country:US
Mailing Address - Phone:561-982-2189
Mailing Address - Fax:305-364-2173
Practice Address - Street 1:2001 W 68TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-1801
Practice Address - Country:US
Practice Address - Phone:305-823-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LIFEMARK HOSPITALS OF FLORIDA, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-18
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4313273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
10-S187Medicare PIN