Provider Demographics
NPI:1568493641
Name:LIFEMARK HOSPITALS OF FLORIDA, INC.
Entity Type:Organization
Organization Name:LIFEMARK HOSPITALS OF FLORIDA, INC.
Other - Org Name:PALMETTO GENERAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP GOVT PROGRAMS, TENET HEALTHCARE
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:C
Authorized Official - Last Name:ARMIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-436-2267
Mailing Address - Street 1:PO BOX 740763
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-0763
Mailing Address - Country:US
Mailing Address - Phone:561-982-2189
Mailing Address - Fax:305-364-2173
Practice Address - Street 1:2001 W 68TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-1801
Practice Address - Country:US
Practice Address - Phone:305-823-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4313282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
100187B000000OtherSECTION 1011
203013380OtherAETNA US HEALTHCARE
990211OtherNEIGHBORHOOD HEALTH PLAN
85045OtherCOVENTRY HEALTH CARE LOUI
266OtherBCBS OF FLORIDA
FL010460400Medicaid
080090OtherHUMANA
101820OtherAVMED
101820OtherAVMED