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NPI Code Detail

MEDICARE: NORTH FLORIDA MEDICAL GROUP, LLC

MEDICARE: NORTH FLORIDA MEDICAL GROUP, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QU0200XUrgent Care Clinic/Center

General Provider Information

NPI Number : 1154633873
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTH FLORIDA MEDICAL GROUP, LLC
Provider Business Mailing Address
First Line : 1702 OHIO AVE
Second Line :
City : LYNN HAVEN
State : FL
Zip : 32444-4290
Country : US
Telephone Number : 850-867-7812
Fax Number : 850-747-2016
Provider Business Practice Location Address
First Line : 1702 OHIO AVE
Second Line :
City : LYNN HAVEN
State : FL
Zip : 32444-4290
Country : US
Telephone Number : 850-867-7812
Fax Number : 850-747-2016
Authorized Official
Title or Position : PRESIDENT/CEO
Name : WILLIAM RODMAN RHODES
Credential : ARNP
Telephone Number : 850-867-7812
Provider Enumeration Date : 07/10/2010
Last Update Date : 07/10/2010

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Directions to “NORTH FLORIDA MEDICAL GROUP, LLC ” Practice Location

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