Provider Demographics
NPI:1982688230
Name:SOUTH MIAMI HOSPITAL INC
Entity Type:Organization
Organization Name:SOUTH MIAMI HOSPITAL INC
Other - Org Name:SOUTH MIAMI HOSPITAL
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:DUQUETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-662-7111
Mailing Address - Street 1:6855 RED RD
Mailing Address - Street 2:STE 500
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33143-3623
Mailing Address - Country:US
Mailing Address - Phone:786-662-7980
Mailing Address - Fax:786-533-9403
Practice Address - Street 1:6200 SW 73RD ST
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4679
Practice Address - Country:US
Practice Address - Phone:786-662-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-30
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4033282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL673316OtherAETNA HMO
FL94530OtherAMERIGROUP
FL1507OtherMEDICA
FL244OtherBLUE CROSS BLUE SHIELD
FL438155OtherUNITED HEALTHCARE
FL010058700Medicaid
FL6201215OtherAETNA NON HMO
FLSMIAMI1000OtherNEIGHBORHOOD HEALTH
FL101684OtherAVMED
FL673316OtherAETNA HMO