Provider Demographics
NPI:1346519816
Name:ST. JOSEPH'S HOSPITAL, INC.
Entity Type:Organization
Organization Name:ST. JOSEPH'S HOSPITAL, INC.
Other - Org Name:ST. JOSEPH'S WOMEN'S HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP, PATIENT FINANCIAL SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GORKEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-281-9479
Mailing Address - Street 1:3001 W DR MLK JR. BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6307
Mailing Address - Country:US
Mailing Address - Phone:813-870-4000
Mailing Address - Fax:813-870-4639
Practice Address - Street 1:3030 W. DR. MLK JR BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6307
Practice Address - Country:US
Practice Address - Phone:813-870-4000
Practice Address - Fax:813-870-4639
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. JOSEPH'S HOSPITAL, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-12-29
Last Update Date:2019-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4292282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFL0100978-02Medicaid
FL100075Medicare Oscar/Certification