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DSH100007FZ Florida Hospital (Terminated)
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Main Details
Name
Florida Hospital
Subdivision Name
Winter Park / 1037 WPMH PET
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH100007FZ
Medicare Provider Number
100007
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/3/2015
Participating Start Date
7/1/2015
Participating Approval Date
5/20/2015
Last Recertification Date
8/25/2015
Termination Date
Termination Reason
10/1/2015
Site closure
Contacts
Authorizing Official
AdventHealth Orlando
Daniel Myers, Senior Vice President Finance
(407) 303-5501
Primary Contact
Florida Hospital
Daniel Myers, Senior Vice President Finance
(407) 303-5501
Addresses
Street Address
200 N. Lakemont Ave.
Winter Park, FL 32792-3273
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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