Provider Demographics
NPI:1114964244
Name:HCA HEALTH SERVICES OF FLORIDA, INC.
Entity Type:Organization
Organization Name:HCA HEALTH SERVICES OF FLORIDA, INC.
Other - Org Name:HCA FLORIDA BLAKE HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-798-6114
Mailing Address - Street 1:2020 59TH ST W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-4604
Mailing Address - Country:US
Mailing Address - Phone:941-792-6611
Mailing Address - Fax:941-798-6209
Practice Address - Street 1:2020 59TH ST W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-4604
Practice Address - Country:US
Practice Address - Phone:941-792-6611
Practice Address - Fax:941-798-6209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA21164OtherWELLCARE
MI404862948Medicaid
560015OtherAETNA
GA840875575BMedicaid
FL000030949OtherHUMANA
GA000593832XMedicaid
032080500OtherBLACK LUNG
21164OtherWELLCARE/STAYWELL
FL567OtherBLUE CROSS
FL011021300Medicaid
NY02847809Medicaid
MI304862909Medicaid
SC11681BMedicaid
TN100213Medicaid
PA1517234OtherGATEWAY HEALTH
TN100213Medicaid
100213Medicare Oscar/Certification