Organization
MERCY HOSPITAL INC
Active
Other names
Section 1011 Program Medicare
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN E MATUSKA CEO (CHIEF EXECUTIVE OFFICER)
(305) 854-4400
Entity
Organization
Contact information
Practice address
3663 SOUTH MIAMI AVENUE, MIAMI, FL 33133
(305) 860-5239
(305) 860-4668
Mailing address
3663 SOUTH MIAMI AVENUE, MIAMI, FL 33133
(305) 860-5239
(305) 860-4668
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
229
BLUE CROSS BLUE SHIELD
FL
Enumeration date
09/29/2006
Last updated
08/22/2020
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