Provider Demographics
NPI:1962844167
Name:WEST FLORIDA - MHT LLC
Entity type:Organization
Organization Name:WEST FLORIDA - MHT LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:M
Authorized Official - Last Name:HARVEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-873-6400
Mailing Address - Street 1:2901 W SWANN AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-4056
Mailing Address - Country:US
Mailing Address - Phone:813-873-6400
Mailing Address - Fax:
Practice Address - Street 1:2901 W SWANN AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-4056
Practice Address - Country:US
Practice Address - Phone:813-873-6400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WEST FLORIDA - MHT, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-07-29
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
10S206Medicare Oscar/Certification