Provider Demographics
NPI:1265481238
Name:SOUTH FLORIDA BAPTIST HOSPITAL INC
Entity Type:Organization
Organization Name:SOUTH FLORIDA BAPTIST HOSPITAL INC
Other - Org Name:FOCUS WOMEN'S GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:BILL
Authorized Official - Middle Name:
Authorized Official - Last Name:ULBRICHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-759-1668
Mailing Address - Street 1:406 N REO ST
Mailing Address - Street 2:SUITE 220
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-1063
Mailing Address - Country:US
Mailing Address - Phone:813-636-2000
Mailing Address - Fax:813-636-2050
Practice Address - Street 1:1603 W REYNOLDS ST
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-4735
Practice Address - Country:US
Practice Address - Phone:813-759-1668
Practice Address - Fax:813-759-6903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL97223AMedicare ID - Type Unspecified