LICENSE OFF-SITE ED SERVICE - Florida

[Pages:2]3/19/2019 11:55:31 AM FDHC\herringe

LICENSE NUMBER 4333 4414 4369

4508 4448

4448 3982 4303 4403

4032 4439 4307 4133 4363 4181 4119 4385 4368

4344 4398 4186 4102 4400

FILE NUMBER 100055 100062 100007

23960099 100088

23960052 100026 100032 100243

100161 100258 100166 100210 100223 100017 100030 100137 100080

100209 100248 100012 100044 100191

PROVIDER NAME

ADVENTHEALTH NORTH APDINVEELNLTAHSEALTH OCALA

ADVENTHEALTH AODRVLEANTDHOEALTH AODRVLEANTDHOEALTH BWAEPSTLIESYT MCHEADPICEALL BCAEPNTIESRT JMAECDKISCOALNVILLE BCAEPNTIESRT JMAECDKISCOALNVILLE BCAEYNTMEERDSICOAULTCHENTER BSAYCFRREODNHTEHAERATLHTEHASLT H BPRETAENRDSOBNURREGGIONAL BHROASNPDITOANL REGIONAL CHEONSTPRITAALLFLORIDA DRELGRIOANYAMLEHDOICSAPLITAL DCOENCTTEORRS HOSPITAL OF FSLAORRAISDOATMAEDICAL FCOENRTEWRA-LATOCNAMBPEUASCHOF HMAELDIFICAAXLHCEEANLTTEHR HMEEADLICTHALCCEENNTTREARL

HEART OF FLORIDA JRFEKGMIOENDAICL AMLECDEICNATLER

JFK MEDICAL CENTER

KENDALL REGIONAL LMAERDGICOAML ECDEINCTAELR LCEEENTMEERMORIAL MHOARSPTINTAMLEDICAL MCEENDTICEARL CENTER OF MTREIDNIICTAYL CENTER OF MTREIDNIICTAYL CENTER OF TRINITY

OFF-SITE EMERGENCY DEPARTMENT NAME

ADVENTHEALTH PALM HARBOR ER ADVENTHEALTH TIMBERRIDGE ER ADVENTHEALTH WINTER GARDEN ER ADVENTHEALTH LAKE MARY ER ADVENTHEALTH CENTRAL PASCO ER BAPTIST EMERGENCY CENTER NORTH BAPTIST EMERGENCY TOWN CENTER BAPTIST EMERGENCY CENTER CLAY BAY MEDICAL SACRED HEART BEACH ER BAYFRONT HEALTH ER PINELLAS PARK ER 24/7 IN TEMPLE TERRACE, A DEPT OF BRANDON RBREGHIEOMNEARLGHEONSCPYITCAELNTER AT PLANT CITY CENTRAL FLORIDA REGIONAL HOSPITAL ER AT IENMTEERRGNEANTICOYNCAELNPTAERRKWLAAKYE WORTH DOCTORS HOSPITAL OF SARASOTA ER IN LAKEWOOD REMANECRHGENCY CENTER AT DAVIE DESTIN EMERGENCY CARE CENTER HALIFAX HEALTH MEDICAL CENTER DELTONA ORLANDO HEALTH EMERGENCY ROOM AND MEDICAL PHAEVAIRLTLIONF FHLOORRIZIDOANRWEEGSIOTNAL MEDICAL CENTER FOUR JCFOKRMNEDRISCEARL CENTER EMERGENCY ROOM BOYNTON JBFEKACMHEDICAL CENTER EMERGENCY ROOM PALM BEACH GTOAWRDNEANNSD COUNTRY EMERGENCY ROOM, A CAMPUS OF KCELENADRAWLLARTEGRIEORN,AAL DEPARTMENT OF LARGO MEDICAL CLEEENTHEERALTH COCONUT POINT MARTIN MEMORIAL EMERGENCY CENTER AT ST LUCIE WERES24T/7 IN LUTZ, A DEPARTMENT OF MEDICAL CENTER OERF 2T4R/I7NMITEYDICAL CENTER OF TRINITY IN PALM HARBOR CITRUS PARK ER - A DEPARTMENT OF MEDICAL CENTER OF TRINITY

Hospital Off-Site ED 03-19-19.xlsx

OFF-SITE ED SERVICE LOCATION A A A B A B A A A A B A A A A A A A A A B A A A A A C B A

EFFECTIVE DATE 12/28/2016 4/16/2002 2/15/2016 05/31/2016 01/29/2018 09/28/2016 04/12/2016 5/1/2013 06/26/2017 12/19/2018 01/30/2018 10/3/2012 02/12/2019 4/25/2016 03/26/2018 6/3/2015 10/30/2003 04/14/2017 09/28/2018 03/08/2019 3/11/2013 10/15/2012 07/20/2018 11/21/2014 01/22/2019 08/18/2009 01/29/2018 11/23/2016 6/10/2015

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4001 4354 4393 4450 4191 4180

4193 4080 4044 4286

4283 4318 4505 4399

100179

100127 100034

100018

100204

100212 100226 120002 100110 100087 100051

100260 100135 100128 100113

110008 100231 23960064 100228

MEMORIAL HOSPITAL MEMORIAL EMERGENCY CARE CENTER JULINGTON

MJAECMKOSROINAVLIHLLOESPITAL CMREEMEOKRIAL EMERGENCY CENTER - ATLANTIC

MJAECMKOSROINAVLIHLLOESPITAL MEMORIAL EMERGENCY CENTER - MANDARIN

MJAOCRKTSOONNVPILLALNET

BARDMOOR EMERGENCY CENTER

MHOOSUPNIT ASLINAI MEDICAL HIALEAH EMERGENCY DEPARTMENT AND SPECIALTY

MCEONUTNETRSINAI MEDICAL CEMAREERGOEFNFCICYEMS OUNT SINAI

NCAEPNLTEESR COMMUNITY NCH BONITA

NHAOPSLPEITSACLOMMUNITY NCH NORTHEAST

NHORSPTHITAFLORIDA

NORTH FLORIDA REGIONAL MEDICAL CENTER

NROEGRITOHNFALLOMREIDDAICAL

ENMOERRTHGEFNLOCYRIWDAESRTEGENIODNAL MEDICAL CENTER

ORECGALIOANRAELGMIOENDAICLAL

ESMUMERMGEERNFCIEYLDMIELMLHEORPGPEENRCY ROOM

OMREADNICGAEL PCAERNKTEMREDICAL PARK WEST EMERGENCY ROOM A CAMPUS OF ORANGE

OCERNLATNERDO HEALTH DR P POARRLKANMDEODIHCEAALLCTEHNETMEERRGENCY ROOM AND MEDICAL

OPHSICLELIOPLSAHROESGPIIOTNAAL L

PHAUVNITLEIORNS -CORSECEEKOELRA

SMAERDAICSAOLTCAEMNETMEORRIAL SARASOTA MEMORIAL NORTH PORT EMERGENCY ROOM

SHOUSTPHITALALKE HOSPITAL SOUTH LAKE HOSPITAL HEALTH PAVILION AT BLUE

SOUTH LAKE HOSPITAL SCOEDUATRH LAKE HOSPITAL JOE H & LORETTA SCOTT EMER

ST LUCIE MEDICAL

RSTOOLUMCAIENDMEMDEIDCIACLACLENTER EMERGENCY ROOM AT

TCAELNLTAEHRASSEE

DTALRLWAHINASQSEUEARMEEMORIAL EMERGENCY CENTER -

TMAEMMPOARGIAELNHEORSAPLITAL NTGOHRTEHMEEARSGTENCY CENTER BRANDON

UHFOSHPEIATLATLH SHANDS

UF HEALTH SHANDS EMERGENCY CENTER - SPRINGHILL

UHFOSHPEIATLATLH SHANDS

UF HEALTH EMERGENCY CENTER - KANAPAHA

WHOESSPTITBAOLCA MEDICAL WEST BOCA MEDICAL CENTER EMERGENCY CARE AT

WCEENSTTEFRLORIDA

CWOECSOTNFULOT RCIRDEAEHKOSPITAL PERDIDO BAY ER

WHOESSPTITKAELNDALL BAPTIST BAPTIST HEALTH EMERGENCY CARE-COUNTRY WALK

WHOESSPTISTIADLE REGIONAL WESTSIDE REGIONAL MEDICAL CENTER EMERGENCY

MEDICAL CENTER

SERVICES IN DAVIE

3/19/2019 11:55:31 AM FDHC\herringe

B

6/10/2015

A

10/25/2012

C

11/28/2016

A

3/3/2008

B

11/07/2018

A

1/11/2008

B

12/21/2018

A

11/24/2015

A

04/05/2017

B

12/01/2017

A

8/1/2015

A

8/1/2015

A

01/02/2019

A

6/6/2014

A

9/1/2009

A

06/04/2018

B

07/31/2018

A

6/12/2015

A

7/12/2013

A

03/27/2017

A

8/1/2013

B

10/01/2016

A

7/14/2015

A

04/19/2018

A

12/06/2018

A

5/14/2015

Hospital Off-Site ED 03-19-19.xlsx

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