Provider Demographics
NPI:1164476867
Name:SUN CITY HOSPITAL INC
Entity type:Organization
Organization Name:SUN CITY HOSPITAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:KAMARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH-FRAYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-634-3301
Mailing Address - Street 1:4016 SUN CITY CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:SUN CITY CENTER
Mailing Address - State:FL
Mailing Address - Zip Code:33573-5256
Mailing Address - Country:US
Mailing Address - Phone:813-634-3301
Mailing Address - Fax:813-634-8712
Practice Address - Street 1:4016 STATE ROAD 674
Practice Address - Street 2:
Practice Address - City:SUN CITY CENTER
Practice Address - State:FL
Practice Address - Zip Code:33573-5256
Practice Address - Country:US
Practice Address - Phone:813-634-3301
Practice Address - Fax:813-634-8712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL000000037680Medicaid
031149000OtherBLACK LUNG
GA20670OtherWELLCARE
PA30021737OtherKEYSTONE MERCY
TN99605Medicaid
20670OtherWELLCARE/STAYWELL
GA88409OtherAMERIGROUP
0068900OtherAETNA
MI404862785Medicaid
FL011994600Medicaid
NY01344325Medicaid
AL0259NMedicaid
SC11639BMedicaid
FL580OtherBLUE CROSS
MI304862776Medicaid
FL000037941OtherHUMANA
GA000810774XMedicaid
OH960107Medicaid
FL011994600Medicaid