Healthcare Provider Details
I. General information
NPI: 1083403661
Provider Name (Legal Business Name): SHANDS TEACHING HOSPITAL AND CLINICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/01/2025
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1535 GALE LEMERAND DR FL 3
GAINESVILLE FL
32610-3008
US
IV. Provider business mailing address
PO BOX 100303
GAINESVILLE FL
32610-0303
US
V. Phone/Fax
- Phone: 352-273-9400
- Fax: 352-627-4268
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 282N00000X |
| Taxonomy | General Acute Care Hospital |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHAEL
D.
HOLMES
Title or Position: CEO
Credential:
Phone: 352-733-1500