Provider Demographics
NPI:1629023015
Name:HCA HEALTH SERVICES OF FLORIDA, INC.
Entity Type:Organization
Organization Name:HCA HEALTH SERVICES OF FLORIDA, INC.
Other - Org Name:BLAKE MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-798-6114
Mailing Address - Street 1:2020 59TH ST W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-4604
Mailing Address - Country:US
Mailing Address - Phone:941-792-6611
Mailing Address - Fax:941-798-6209
Practice Address - Street 1:2020 59TH ST W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-4604
Practice Address - Country:US
Practice Address - Phone:941-792-6611
Practice Address - Fax:941-798-6209
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HCA HEALTH SERVICES OF FLORIDA, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-23
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
10T213Medicare Oscar/Certification