Provider Demographics
NPI:1114163912
Name:TARPON SPRINGS HOSPITAL FOUNDATION INC
Entity Type:Organization
Organization Name:TARPON SPRINGS HOSPITAL FOUNDATION INC
Other - Org Name:FLORIDA HOSPITAL NORTH PINELLAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUNK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-942-5107
Mailing Address - Street 1:1395 S PINELLAS AVE
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34689-3790
Mailing Address - Country:US
Mailing Address - Phone:727-942-5000
Mailing Address - Fax:
Practice Address - Street 1:1395 S PINELLAS AVE
Practice Address - Street 2:
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34689-3790
Practice Address - Country:US
Practice Address - Phone:727-942-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-29
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL105912Medicare Oscar/Certification