Provider Demographics
NPI:1093791303
Name:MORTON PLANT HOSPITAL ASSOCIATION, INC
Entity Type:Organization
Organization Name:MORTON PLANT HOSPITAL ASSOCIATION, INC
Other - Org Name:MORTON PLANT REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO, BAYCARE HOSPITAL DIVISION
Authorized Official - Prefix:MR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:
Authorized Official - Last Name:TREMONTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-462-7176
Mailing Address - Street 1:400 CORBETT ST
Mailing Address - Street 2:
Mailing Address - City:BELLEAIR
Mailing Address - State:FL
Mailing Address - Zip Code:33756-3344
Mailing Address - Country:US
Mailing Address - Phone:727-462-7600
Mailing Address - Fax:727-298-6064
Practice Address - Street 1:400 CORBETT ST
Practice Address - Street 2:
Practice Address - City:BELLEAIR
Practice Address - State:FL
Practice Address - Zip Code:33756-3344
Practice Address - Country:US
Practice Address - Phone:727-462-7600
Practice Address - Fax:727-298-6064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-19
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSNF1358095314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0206431-00Medicaid
FL0206431-00Medicaid