Provider Demographics
NPI: | 1033001748 |
---|---|
Name: | VARIETY CHILDREN'S HOSPITAL, INC. |
Entity type: | Organization |
Organization Name: | VARIETY CHILDREN'S HOSPITAL, INC. |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | SVP/CFO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | DAWN |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | JAVERSACK |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 305-666-6511 |
Mailing Address - Street 1: | 3100 SW 62ND AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | MIAMI |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33155-3009 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 305-665-6511 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 3000 CORAL HILLS DR |
Practice Address - Street 2: | |
Practice Address - City: | CORAL SPRINGS |
Practice Address - State: | FL |
Practice Address - Zip Code: | 33065-4108 |
Practice Address - Country: | US |
Practice Address - Phone: | 305-666-6511 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | VARIETY CHILDREN'S HOSPITAL, INC. |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2025-07-17 |
Last Update Date: | 2025-07-23 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 282N00000X | Hospitals | General Acute Care Hospital | |
No | 282NC2000X | Hospitals | General Acute Care Hospital | Children |