Organization
DESOTO MEMORIAL HOSPITAL INC
Active
Other names
DeSoto Memorial Center for Family Health
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VINCENT A SICA (CEO)
(863) 494-8403
Entity
Organization
Contact information
Practice address
888 N ROBERTS AVE, ARCADIA, FL 34266-9580
(863) 494-8401
(863) 491-4328
Mailing address
888 N ROBERTS AVE, ARCADIA, FL 34266-9580
(863) 494-8401
(863) 491-4328
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
4218
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00746
MEDICARE
FL
05
—
252217900
—
FL
05
—
660074300
—
FL
Enumeration date
09/29/2006
Last updated
03/28/2011
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