Winter Haven Hospital Inc
Organization Active NPI Clinical Cardiac Electrophysiology Physician · Winter Haven, FL
NPI 1780150524 · NPPES record last updated Aug 6, 2024
Key facts
- NPI
- 1780150524
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Cardiac Electrophysiology Physician 207RC0001X
- Legal business name
- WINTER HAVEN HOSPITAL INC
- Practice address
- 200 Avenue F NE FL 2
Winter Haven, FL 33881-4131 - Phone
- (863) 293-1121
- NPI assigned
- Oct 19, 2018
- Organization subpart
- No
Authorized official
- Name
- Lynda A Gorken
- Title
- VP, PFS
- Phone
- (727) 281-9390
Other NPIs on the same Medicare enrollment 1
Corporate family (same tax ID) 5
Practitioners 68
-
Aliris Alicea, LMHC, CCMHC, NCC
-
Jeanne Ryan Botz, ARNP
-
Brenda G Burnett, D.O.
-
Darina Carcerano, NP
-
Sheryl Carney, ARNP
-
Rakesh Choubey, MD
-
Katlyn Marie Eastridge, LCSW
-
Adrienne R Eisner, M.D.
-
Marc Ettensohn, M.D.
-
Ruth Lynn Gaines, ARNP
-
Mary D Gambrell, LCSW, CAP
-
Wil Edvard Germain, M.D.
-
Cody Lane Goers, LMHC
-
Jennifer M. Gonatos, MSW, LCSW
-
Benita Cardell Hayes, MSW-LCSW
-
Kayla Victoria Hobbs, LCSW
-
Debra L Hogan, LCSW
-
Carrie Hughes, LMHC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040210000095 | FL | Part B Supplier - Clinic/Group Practice | 4789578972 |
Receives reassigned benefits from 176 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Winter Haven, FL; Lake Wales, FL; Haines City, FL; Bartow, FL; Auburndale, FL |
National Provider Directory
- Tax ID family
- Winter Haven Hosp
Locations
511 6th Ave
Ste 7260
New York, NY 10011
Phone (917) 929-7661
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Cardiac Electrophysiology Physician |
207RC0001X | Yes |
Addresses
Primary practice location
200 Avenue F NE FL 2
Winter Haven, FL 33881-4131
Mailing address
2995 Drew Street
East BLDG 2ND Floor
Clearwater, FL 33759
Phone (727) 281-9390
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 010169904 | Medicaid | FL |
Other names
- WH Physician Billing EKG
Other providers in Winter Haven, FL
- Winter Haven Hospital Inc
- Winter Haven Hospital Inc
- Winter Haven Hospital Inc
- Winter Haven Hospital Inc
- Winter Haven Hospital Inc
- Winter Haven Hospital Inc
- Winter Haven Hospital Inc
- Winter Haven Intensive Care Consultants PLLC
- Winter Haven Modern Dentistry, PA
- Winter Haven Nursing LLC
All providers in Winter Haven, FL · Clinical Cardiac Electrophysiology Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 6, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.