Provider Demographics
NPI:1689088304
Name:FLORIDA HOSPITAL
Entity Type:Organization
Organization Name:FLORIDA HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRNA
Authorized Official - Prefix:
Authorized Official - First Name:ZAMZAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ELGHOUL
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:313-205-9411
Mailing Address - Street 1:7922 BARRIE ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-1062
Mailing Address - Country:US
Mailing Address - Phone:313-205-9411
Mailing Address - Fax:
Practice Address - Street 1:7922 BARRIE
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126
Practice Address - Country:US
Practice Address - Phone:313-205-9411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-20
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS93361282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital