Provider Demographics
NPI:1013434067
Name:ADVENTIST HEALTH SYSTEM-SUNBELT INC
Entity Type:Organization
Organization Name:ADVENTIST HEALTH SYSTEM-SUNBELT INC
Other - Org Name:FROSTPROOF FAMILY HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMASON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-402-3366
Mailing Address - Street 1:4101 SUN N LAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33872-2131
Mailing Address - Country:US
Mailing Address - Phone:863-314-4466
Mailing Address - Fax:
Practice Address - Street 1:200 S SCENIC HWY
Practice Address - Street 2:
Practice Address - City:FROSTPROOF
Practice Address - State:FL
Practice Address - Zip Code:33843-2125
Practice Address - Country:US
Practice Address - Phone:863-546-6384
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVENTIST HEALTH SYSTEM-SUNBELT INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-08-29
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL010260100Medicaid