Basic Information
| Provider Information | |||||||||
| NPI: | 1235663899 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | STEWARD ROCKLEDGE HOSPITAL, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1900 N PEARL ST STE 2400 | ||||||||
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| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752012470 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4693418800 | ||||||||
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| Practice Location | |||||||||
| Address1: | 110 LONGWOOD AVE | ||||||||
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| City: | ROCKLEDGE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 329552828 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3216362211 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2017 | ||||||||
| LastUpdateDate: | 06/04/2019 | ||||||||
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| AuthorizedOfficialLastName: | DOYLE | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 4693418804 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 273R00000X | N | Hospital Units | Psychiatric Unit | 282N00000X | 4132 | FL | Y | Hospitals | General Acute Care Hospital |
No ID Information.