Provider Demographics
NPI:1902857386
Name:MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC
Entity Type:Organization
Organization Name:MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC
Other - Org Name:MOUNT SINAI HOSPITAL OF GREATER MIAMI, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:VICE PRESIDENT OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUTKAN
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:305-674-2662
Mailing Address - Street 1:4300 ALTON RD
Mailing Address - Street 2:5 WARNER
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2800
Mailing Address - Country:US
Mailing Address - Phone:305-674-2662
Mailing Address - Fax:305-674-2007
Practice Address - Street 1:4300 ALTON RD
Practice Address - Street 2:5 WARNER
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2800
Practice Address - Country:US
Practice Address - Phone:305-674-2662
Practice Address - Fax:305-674-2007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4066273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10S034Medicare Oscar/Certification