| Hawthorne Medical Center, Inc. | |
|
21815 S.e .71st Avenue Hawthorne FL 32640-3974 | |
| (352) 481-2400 | |
| (352) 481-2777 |
| Full Name | Hawthorne Medical Center, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 21815 S.e .71st Avenue, Hawthorne, Florida |
| Authorized Official Name and Position | Patricia O Mccullough (PRESIDENT/OWNER) |
| Authorized Official Contact | 3524812400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hawthorne Medical Center, Inc. 21815 S.e .71st Avenue Hawthorne FL 32640-3974 Ph: (352) 481-2400 | Hawthorne Medical Center, Inc. 21815 S.e .71st Avenue Hawthorne FL 32640-3974 Ph: (352) 481-2400 |
| NPI Number | 1023196318 |
|---|---|
| Provider Enumeration Date | 11/02/2006 |
| Last Update Date | 07/06/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023196318 | NPI | - | NPPES |
| 37209S100 | Medicaid | FL | |
| 45696 | Other | FL | BLUE CROSS BLUE SHIELD |
| 18622 | Other | FL | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME63062 (Florida) | Secondary |
| 207Q00000X | Family Medicine | HCC8421 (Florida) | Primary |
Aza Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 22066 Se 71st Avenue, Hawthorne, FL 32640 Phone: 352-481-2700 Fax: 352-481-2392 | |
David M. Trax, D.c., P.a. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6005 Se Us Highway 301, Suite 405 A, Hawthorne, FL 32640 Phone: 352-481-9994 Fax: 352-481-9954 | |
Open Arms Medical Center At Hawthorne, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6435 Se Us Highway 301, Hawthorne, FL 32640 Phone: 352-481-5700 Fax: 352-481-5750 | |
Mulberrys Mobile Provider Services, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6435 Se Us Highway 301, Hawthorne, FL 32640 Phone: 352-358-8070 Fax: 949-577-4783 | |
Sorrid Medical Consultants Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 640 Lake Susan Rd, Hawthorne, FL 32640 Phone: 352-246-0936 |