Provider Demographics
NPI:1285681908
Name:CENTRAL FLORIDA REGIONAL HOSPITAL, INC
Entity Type:Organization
Organization Name:CENTRAL FLORIDA REGIONAL HOSPITAL, INC
Other - Org Name:HCA FLORIDA LAKE MONROE HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:BORING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-302-7362
Mailing Address - Street 1:1401 W SEMINOLE BLVD
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-6737
Mailing Address - Country:US
Mailing Address - Phone:407-321-4500
Mailing Address - Fax:407-324-4790
Practice Address - Street 1:1401 W SEMINOLE BLVD
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-6737
Practice Address - Country:US
Practice Address - Phone:407-321-4500
Practice Address - Fax:407-324-4790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL228382OtherAMERIGROUP
FL322OtherBLUE CROSS
FL10178800Medicaid
MA7029888Medicaid
GA000589245XMedicaid
FL089001OtherAVMED
NY01557262Medicaid
SC10650BMedicaid
FL228382OtherAMERIGROUP