Provider Demographics
NPI:1417994518
Name:NOTAMI HOSPITALS OF FLORIDA INC
Entity Type:Organization
Organization Name:NOTAMI HOSPITALS OF FLORIDA INC
Other - Org Name:LAKE CITY MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-719-9012
Mailing Address - Street 1:340 NW COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32055-4709
Mailing Address - Country:US
Mailing Address - Phone:386-719-9000
Mailing Address - Fax:386-719-7787
Practice Address - Street 1:340 NW COMMERCE DR
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32055-4709
Practice Address - Country:US
Practice Address - Phone:386-719-9000
Practice Address - Fax:386-719-7787
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NOTAMI HOSPITALS OF FLORIDA INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-31
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
10S156Medicare Oscar/Certification