Provider Demographics
NPI:1578549432
Name:MORTON PLANT HOSPITAL ASSOCIATION INC
Entity Type:Organization
Organization Name:MORTON PLANT HOSPITAL ASSOCIATION INC
Other - Org Name:MORTON PLANT NORTH BAY REHAB UNIT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO, BAYCARE HOSPITAL DIVISION
Authorized Official - Prefix:MR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:
Authorized Official - Last Name:TREMONTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-462-7176
Mailing Address - Street 1:6600 MADISON ST
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-1971
Mailing Address - Country:US
Mailing Address - Phone:727-843-4500
Mailing Address - Fax:727-848-8762
Practice Address - Street 1:6600 MADISON ST
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-1971
Practice Address - Country:US
Practice Address - Phone:727-843-4500
Practice Address - Fax:727-848-8762
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MORTON PLANT HOSPITAL ASSOCIATION INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-12-21
Last Update Date:2013-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4216273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0101508-01Medicaid
FL10T063Medicare Oscar/Certification