Provider Demographics
NPI:1194968396
Name:HOSPITAL SPECIALISTS
Entity type:Organization
Organization Name:HOSPITAL SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:G
Authorized Official - Last Name:PAVLAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-246-7494
Mailing Address - Street 1:2041 SEAGIRT BLVD APT 4G
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-5803
Mailing Address - Country:US
Mailing Address - Phone:347-246-7494
Mailing Address - Fax:
Practice Address - Street 1:4466 SWILCAN BRIDGE LN N
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224-5617
Practice Address - Country:US
Practice Address - Phone:904-962-2694
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-17
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME103761282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital