Healthcare Provider Details

I. General information

NPI: 1134308489
Provider Name (Legal Business Name): SHANDS TEACHING HOSPITAL AND CLINICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2007
Last Update Date: 12/31/2025
Certification Date: 12/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2409 SW ARCHER RD
GAINESVILLE FL
32608-1305
US

IV. Provider business mailing address

PO BOX 100303
GAINESVILLE FL
32610-0303
US

V. Phone/Fax

Practice location:
  • Phone: 352-265-6890
  • Fax: 352-733-0069
Mailing address:
  • Phone: 352-627-9045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL D. HOLMES
Title or Position: CEO
Credential:
Phone: 352-733-1500