Healthcare Provider Details

I. General information

NPI: 1427087717
Provider Name (Legal Business Name): SUWANNEE COUNTY BOARD OF COUNTY COMMISSIONERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2006
Last Update Date: 06/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13530 80TH TERRACE
LIVE OAK FL
32060
US

IV. Provider business mailing address

13530 80TH TERRACE
LIVE OAK FL
32060-8868
US

V. Phone/Fax

Practice location:
  • Phone: 386-364-3404
  • Fax: 386-364-1256
Mailing address:
  • Phone: 386-364-3404
  • Fax: 386-364-1256

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number3603
License Number StateFL

VIII. Authorized Official

Name: JAMES E SOMMERS
Title or Position: PUBLIC SAFETY DIRECTOR
Credential:
Phone: 386-364-3404