Healthcare Provider Details

I. General information

NPI: 1699199299
Provider Name (Legal Business Name): REGIONAL HEALTH PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2014
Last Update Date: 04/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 SW 7TH ST
WILLISTON FL
32696-2403
US

IV. Provider business mailing address

PO BOX 130
WILLISTON FL
32696-0130
US

V. Phone/Fax

Practice location:
  • Phone: 352-528-2801
  • Fax: 352-528-1493
Mailing address:
  • Phone: 352-528-2801
  • Fax: 352-528-1493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: EDITH E MEARS
Title or Position: CEO
Credential:
Phone: 352-528-2801