Provider Demographics
NPI:1881632818
Name:ST. JOSEPH'S HOSPITAL, INC.
Entity Type:Organization
Organization Name:ST. JOSEPH'S HOSPITAL, INC.
Other - Org Name:ST. JOSEPH'S HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP, PATIENT FINANCIAL SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GORKEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-281-9479
Mailing Address - Street 1:3001 W DR MLK JR BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6307
Mailing Address - Country:US
Mailing Address - Phone:813-870-4000
Mailing Address - Fax:813-870-4639
Practice Address - Street 1:3001 W DR MLK JR BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6307
Practice Address - Country:US
Practice Address - Phone:813-870-4000
Practice Address - Fax:813-870-4639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
273R00000X, 363LN0000X
FL4292282N00000X
FL10D0290262291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282N00000XHospitalsGeneral Acute Care HospitalGroup - Multi-Specialty
No273R00000XHospital UnitsPsychiatric Unit
No291U00000XLaboratoriesClinical Medical LaboratoryGroup - Multi-Specialty
No363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10D0290262OtherCLIA
FLFL0100978Medicaid
FLFL0100978Medicaid
FL10D0290262OtherCLIA