Healthcare Provider Details

I. General information

NPI: 1598948077
Provider Name (Legal Business Name): NORTH FLORIDA/SOUTH GEORGIA VETERANS HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2007
Last Update Date: 12/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 SW ARCHER RD
GAINESVILLE FL
32608-1135
US

IV. Provider business mailing address

5505 SW 93RD WAY
GAINESVILLE FL
32608-4329
US

V. Phone/Fax

Practice location:
  • Phone: 352-374-6087
  • Fax:
Mailing address:
  • Phone: 352-373-9577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code286500000X
TaxonomyMilitary Hospital
License Number
License Number StateFL

VIII. Authorized Official

Name: MRS. ROSE WHITTLE ANDERSON
Title or Position: R.N.
Credential: R.N.
Phone: 352-373-9577