Healthcare Provider Details

I. General information

NPI: 1861397960
Provider Name (Legal Business Name): HMA SANTA ROSA MEDICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

4250 WOODBINE RD
PACE FL
32571-8703
US

IV. Provider business mailing address

6002 BERRYHILL RD
MILTON FL
32570-5062
US

V. Phone/Fax

Practice location:
  • Phone: 850-983-4486
  • Fax: 850-994-4271
Mailing address:
  • Phone: 850-626-7762
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: PAULA LALOR
Title or Position: SENIOR DIRECTOR
Credential:
Phone: 629-215-3953