Provider Demographics
NPI:1891347274
Name:AETNA HEALTH INC. A FLORIDA CORPORATION
Entity Type:Organization
Organization Name:AETNA HEALTH INC. A FLORIDA CORPORATION
Other - Org Name:COVENTRY HEALTH PLAN OF FLORIDA, INC.
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF MEDICARE OFFICER FLORIDA
Authorized Official - Prefix:MR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCUNNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-858-3138
Mailing Address - Street 1:261 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-2002
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:261 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2002
Practice Address - Country:US
Practice Address - Phone:954-858-3138
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-15
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization