Healthcare Provider Details

I. General information

NPI: 1477424943
Provider Name (Legal Business Name): SHANDS TEACHING HOSPITAL AND CLINICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2025
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14359 SW 2ND PL STE 4 UF HEALTH REHAB CENTER FOR KIDS JONESVILLE
NEWBERRY FL
32669-6376
US

IV. Provider business mailing address

PO BOX 100303
GAINESVILLE FL
32610-0303
US

V. Phone/Fax

Practice location:
  • Phone: 352-265-2777
  • Fax: 352-627-5384
Mailing address:
  • Phone: 352-627-9045
  • Fax: 352-627-9049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: MICHAEL DAVID HOLMES
Title or Position: CEO
Credential:
Phone: 352-733-1500