Provider Demographics
NPI:1841708005
Name:HOSPITAL INNOVATION PHYSICIANS LLC
Entity type:Organization
Organization Name:HOSPITAL INNOVATION PHYSICIANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RUDDY
Authorized Official - Middle Name:
Authorized Official - Last Name:VALDES
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:954-615-7179
Mailing Address - Street 1:3600 RED RD STE 401
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-6014
Mailing Address - Country:US
Mailing Address - Phone:786-457-4900
Mailing Address - Fax:833-548-0457
Practice Address - Street 1:524 W SAGAMORE AVE
Practice Address - Street 2:
Practice Address - City:CLEWISTON
Practice Address - State:FL
Practice Address - Zip Code:33440-3514
Practice Address - Country:US
Practice Address - Phone:386-274-7800
Practice Address - Fax:386-274-7801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-22
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty