Provider Demographics
NPI:1659439156
Name:ADVENTIST HEALTH SYSTEM-SUNBELT, INC
Entity Type:Organization
Organization Name:ADVENTIST HEALTH SYSTEM-SUNBELT, INC
Other - Org Name:FLORIDA HOSPITAL TRANSPLANT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HENDERSON
Authorized Official - Middle Name:
Authorized Official - Last Name:PETER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-200-2227
Mailing Address - Street 1:2415 N ORANGE AVE
Mailing Address - Street 2:SUITE 700
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-5505
Mailing Address - Country:US
Mailing Address - Phone:407-330-3247
Mailing Address - Fax:407-303-2478
Practice Address - Street 1:2415 N ORANGE AVE
Practice Address - Street 2:SUITE 700
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-5505
Practice Address - Country:US
Practice Address - Phone:407-330-3247
Practice Address - Fax:407-303-2478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204F00000XAllopathic & Osteopathic PhysiciansTransplant SurgeryGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RI0008XAllopathic & Osteopathic PhysiciansInternal MedicineHepatologyGroup - Multi-Specialty
No207RT0003XAllopathic & Osteopathic PhysiciansInternal MedicineTransplant HepatologyGroup - Multi-Specialty
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0007OtherMEDICARE GROUP NUMBER
FL74646OtherBLUE CROSS
FL274870301Medicaid