Provider Demographics
NPI:1487020178
Name:ADVENTIST HEALTH SYSTEMS SUNBELT INC
Entity Type:Organization
Organization Name:ADVENTIST HEALTH SYSTEMS SUNBELT INC
Other - Org Name:PALLIATIVE CARE SPECIALISTS AT FLORIDA HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DARYL
Authorized Official - Middle Name:
Authorized Official - Last Name:TOL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-303-1531
Mailing Address - Street 1:2501 N ORANGE AVE
Mailing Address - Street 2:SUITE 235
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-4603
Mailing Address - Country:US
Mailing Address - Phone:407-303-2906
Mailing Address - Fax:407-303-7126
Practice Address - Street 1:2501 N ORANGE AVE
Practice Address - Street 2:SUITE 235
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-4603
Practice Address - Country:US
Practice Address - Phone:407-303-2906
Practice Address - Fax:407-303-7126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-17
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL99794Medicare UPIN