Provider Demographics
NPI:1174823660
Name:MERCY HOSPITAL
Entity Type:Organization
Organization Name:MERCY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT NURSE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHANCILENE
Authorized Official - Middle Name:
Authorized Official - Last Name:COLAS
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:305-285-2170
Mailing Address - Street 1:16900 N BAY RD APT 811
Mailing Address - Street 2:
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-4266
Mailing Address - Country:US
Mailing Address - Phone:954-588-1146
Mailing Address - Fax:
Practice Address - Street 1:16900 N BAY RD APT 811
Practice Address - Street 2:
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-4266
Practice Address - Country:US
Practice Address - Phone:954-588-1146
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-30
Last Update Date:2010-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 2899962282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital