Healthcare Provider Details

I. General information

NPI: 1720751340
Provider Name (Legal Business Name): SHANDS TEACHING HOSPITAL AND CLINICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2021
Last Update Date: 12/31/2025
Certification Date: 12/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-3003
US

IV. Provider business mailing address

PO BOX 100303
GAINESVILLE FL
32610-0303
US

V. Phone/Fax

Practice location:
  • Phone: 352-626-9045
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number
License Number State

VIII. Authorized Official

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