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DSH100007V Florida Hospital (Terminated)
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Main Details
Name
Florida Hospital
Subdivision Name
Florida Hospital 4210/4290 Orlando Diagnostic Imaging
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH100007V
Medicare Provider Number
100007
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/9/2013
Participating Start Date
10/1/2013
Participating Approval Date
7/17/2013
Last Recertification Date
11/17/2017
Termination Date
Termination Reason
10/1/2018
Site closure
Contacts
Authorizing Official
AdventHealth Orlando
Daniel Myers, Senior Vice President Finance
(407) 303-5501
Primary Contact
Florida Hospital
Billy Roger Buot Taer, Reimbursement Manager
(407) 379-1507
Addresses
Street Address
2501 N. Orange Avenue
Suite 375
Orlando, FL 32804
Billing Address
Florida Hospital Orlando
601 E. Rollins St.
Orlando, FL 32803-1248
Comments
Medicaid Billing
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