Healthcare Provider Details

I. General information

NPI: 1689812109
Provider Name (Legal Business Name): HMA/SOLANTIC JOINT VENTURE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2009
Last Update Date: 11/02/2023
Certification Date: 11/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 58TH AVE. UNIT 110
VERO BEACH FL
32966
US

IV. Provider business mailing address

10151 DEERWOOD PARK BLVD STE 200
JACKSONVILLE FL
32256-0566
US

V. Phone/Fax

Practice location:
  • Phone: 772-257-3200
  • Fax: 772-257-0187
Mailing address:
  • Phone: 904-854-1545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: WEBSTER GOLINKIN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 919-550-0821