Healthcare Provider Details

I. General information

NPI: 1942031232
Provider Name (Legal Business Name): SHANDS TEACHING HOSPITAL AND CLINICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2024
Last Update Date: 12/31/2025
Certification Date: 12/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29051 NW 80TH COURT SUITE 200
OCALA FL
34482
US

IV. Provider business mailing address

PO BOX 100303
GAINESVILLE FL
32610-0303
US

V. Phone/Fax

Practice location:
  • Phone: 352-421-7698
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

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