Provider Demographics
NPI:1063442770
Name:HIALEAH HOSPITAL INC.
Entity Type:Organization
Organization Name:HIALEAH HOSPITAL INC.
Other - Org Name:HIALEAH HOSPITAL
Other - Org Type:Doing Business As
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 740922
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-0922
Mailing Address - Country:US
Mailing Address - Phone:561-982-2189
Mailing Address - Fax:305-835-4252
Practice Address - Street 1:651 E 25TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-3814
Practice Address - Country:US
Practice Address - Phone:305-693-6100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4347282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
223387OtherAVMED
FL010041200Medicaid
990111OtherNEIGHBORHOOD HEALTH PLAN
788724700OtherAETNA US HEALTHCARE (NATI
232OtherBCBS OF FLORIDA
080091OtherHUMANA
100053B000000OtherSECTION 1011
100053B000000OtherSECTION 1011