Provider Demographics
NPI:1437765823
Name:SOUTH MIAMI HOSPITAL, INC
Entity Type:Organization
Organization Name:SOUTH MIAMI HOSPITAL, INC
Other - Org Name:BAPTIST HEALTH URGENT CARE AT PLANTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KRANICHFELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-669-2833
Mailing Address - Street 1:6501 CITY WEST PKWY
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-3248
Mailing Address - Country:US
Mailing Address - Phone:952-653-2525
Mailing Address - Fax:
Practice Address - Street 1:1228 S PINE ISLAND RD STE 110
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-4402
Practice Address - Country:US
Practice Address - Phone:954-837-1410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site