Healthcare Provider Details
I. General information
NPI: 1841772316
Provider Name (Legal Business Name): APP OF FLORIDA HM, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/31/2018
Last Update Date: 01/26/2023
Certification Date: 01/26/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6002 BERRYHILL RD
MILTON FL
32570-5062
US
IV. Provider business mailing address
5121 MARYLAND WAY STE 300
BRENTWOOD TN
37027-7516
US
V. Phone/Fax
- Phone: 629-203-7320
- Fax:
- Phone: 629-203-7320
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAMES
GRIMES
Title or Position: CFO
Credential:
Phone: 855-246-8607