LIVE OAK HMA LLC NPI 1669568499

NPI Information

NPI: 1669568499
Provider Name: LIVE OAK HMA, LLC

Doing Business As: SHANDS LIVE OAK MEDICAL GROUP

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
1426 CANYON AVE NE
UNIT B
LIVE OAK, FL
ZIP 32064
Phone: (386) 208-0537
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LIVE OAK HMA, LLC is a rural health clinic center in Live Oak, FL. LIVE OAK HMA, LLC NPI is 1669568499. The provider is registered as an organization entity type.
The provider Is Doing Business As Shands Live Oak Medical Group.

The provider's business location address is:

1426 CANYON AVE NE
UNIT B
LIVE OAK, FL
ZIP 32064-832
Phone: (386) 208-0537

The provider's authorized official is Paula Lalor .
The authorized official title is Director/delegated Official and has the following contact phone number (615) 925-4565.

The enumeration date for this NPI number is 10/5/2006 and was last updated on 2/23/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR1300X	Clinic/Center	Rural Health	4314	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	CE9137	OTHER	FLORIDA	MEDICARE RAIL ROAD
2	660120100	MEDICAID	FLORIDA
3	660120101	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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