Provider Demographics
NPI:1497811962
Name:MERCY HOSPITAL, INC.
Entity Type:Organization
Organization Name:MERCY HOSPITAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MHSA
Authorized Official - Phone:305-285-2994
Mailing Address - Street 1:3663 S MIAMI AVE
Mailing Address - Street 2:SPECIAL IMMUNOLOGY SERVICES
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-4253
Mailing Address - Country:US
Mailing Address - Phone:305-285-2994
Mailing Address - Fax:305-860-4678
Practice Address - Street 1:3663 S MIAMI AVE
Practice Address - Street 2:SPECIAL IMMUNOLOGY SERVICES
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4253
Practice Address - Country:US
Practice Address - Phone:305-285-2994
Practice Address - Fax:305-860-4678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management