Provider Demographics
NPI:1962669952
Name:MORTON PLANT HOSPITAL
Entity Type:Organization
Organization Name:MORTON PLANT HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SIDDIQUE
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:727-442-9041
Mailing Address - Street 1:1120 N BETTY LN
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33755-3303
Mailing Address - Country:US
Mailing Address - Phone:727-442-9041
Mailing Address - Fax:727-446-1516
Practice Address - Street 1:1120 N BETTY LN
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33755-3303
Practice Address - Country:US
Practice Address - Phone:727-442-9041
Practice Address - Fax:727-446-1516
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAYCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1179061282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital