Provider Demographics
NPI:1235186792
Name:VARIETY CHILDREN'S HOSPITAL.
Entity Type:Organization
Organization Name:VARIETY CHILDREN'S HOSPITAL.
Other - Org Name:NCH RADIOLOGY
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR, RCM
Authorized Official - Prefix:MS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-624-5876
Mailing Address - Street 1:PO BOX 865095
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32886-5095
Mailing Address - Country:US
Mailing Address - Phone:786-624-5876
Mailing Address - Fax:786-624-2688
Practice Address - Street 1:3100 SW 62ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-3009
Practice Address - Country:US
Practice Address - Phone:305-662-8293
Practice Address - Fax:305-667-8689
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NICKLAUS CHILDREN'S HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-30
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL256985000Medicaid
FLK9791Medicare PIN