Provider Demographics
NPI:1316531999
Name:ST. JOSEPH'S HOSPITAL, INC.
Entity type:Organization
Organization Name:ST. JOSEPH'S HOSPITAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, PATIENT FINANCIAL SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GORKEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-281-9479
Mailing Address - Street 1:3001 W DR MLK BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6307
Mailing Address - Country:US
Mailing Address - Phone:813-870-4000
Mailing Address - Fax:813-870-4639
Practice Address - Street 1:3001 W DR MLK BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6307
Practice Address - Country:US
Practice Address - Phone:813-870-4000
Practice Address - Fax:813-870-4639
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. JOSEPH'S HOSPITAL, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10D0290262OtherCLIA
FL0100978-06Medicaid
FL0100978-06Medicaid