Provider Demographics
NPI:1821078866
Name:EAST COAST HOSPITAL INPATIENT SPECIALISTS PLC
Entity Type:Organization
Organization Name:EAST COAST HOSPITAL INPATIENT SPECIALISTS PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HASIB
Authorized Official - Middle Name:IBNE
Authorized Official - Last Name:RASA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-936-0976
Mailing Address - Street 1:PO BOX 953457
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32795-3457
Mailing Address - Country:US
Mailing Address - Phone:407-936-0976
Mailing Address - Fax:407-936-0977
Practice Address - Street 1:2500 W LAKE MARY BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-3501
Practice Address - Country:US
Practice Address - Phone:407-936-0976
Practice Address - Fax:407-936-0977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-17
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCK4021OtherRAIL ROAD MEDICARE
FL262536900Medicaid
FL34130OtherBCBS
FL262536900Medicaid