Provider Demographics
NPI:1407915986
Name:ADVENTIST HEALTH SYSTEM SUNBELT INC
Entity Type:Organization
Organization Name:ADVENTIST HEALTH SYSTEM SUNBELT INC
Other - Org Name:THE TRINA HIDALGO HEART CARE CENTER ORLANDO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HENDERSON
Authorized Official - Middle Name:
Authorized Official - Last Name:PETER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-200-2227
Mailing Address - Street 1:PO BOX 538700
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32853-8700
Mailing Address - Country:US
Mailing Address - Phone:407-200-2924
Mailing Address - Fax:407-200-4948
Practice Address - Street 1:101 SOUTH WESTMORELAND DRIVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32805
Practice Address - Country:US
Practice Address - Phone:407-836-9262
Practice Address - Fax:407-836-7163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 973342363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAARNP 977342OtherSTATE LICENSE
FLARNP 1279952OtherSTATE LICENSE