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DSH100007BE Florida Hospital (Terminated)
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Main Details
Name
Florida Hospital
Subdivision Name
Florida Hospital 4200 Kissimmee Clinical Services
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH100007BE
Medicare Provider Number
100007
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/3/2014
Participating Start Date
4/1/2014
Participating Approval Date
3/5/2014
Last Recertification Date
8/25/2015
Termination Date
Termination Reason
4/1/2016
Other
Contacts
Authorizing Official
AdventHealth Orlando
Daniel Myers, Senior Vice President Finance
(407) 303-5501
Primary Contact
Alexsandra Rosello, 340B Business Manager
(321) 578-4744
Addresses
Street Address
201 Hilda Street
Suite 36
Kissimmee, FL 34741
Billing Address
Florida Hospital Kissimmee
2450 N. Orange Blossom Trail
Kissimmee, FL 34744-2316
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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