Provider Demographics
NPI:1346492915
Name:TRICOUNTY HOSPITALISTS LLC
Entity Type:Organization
Organization Name:TRICOUNTY HOSPITALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGRM
Authorized Official - Prefix:
Authorized Official - First Name:SHAHID
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARIF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-506-4016
Mailing Address - Street 1:PO BOX 521165
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32752-1165
Mailing Address - Country:US
Mailing Address - Phone:407-215-5657
Mailing Address - Fax:407-284-1147
Practice Address - Street 1:1906 WINGFIELD DR
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32779-7007
Practice Address - Country:US
Practice Address - Phone:407-215-5657
Practice Address - Fax:407-284-1147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-15
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME92280146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response AttendantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG61488Medicare UPIN