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General NPI Number Information
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NPI Number | 1154633873
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Entity Type | Organization
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Legal Business Name | NORTH FLORIDA MEDICAL GROUP, LLC
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Dates
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Enumeration Date | 07/10/2010
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Last Update Date | 07/10/2010
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Provider Practice Location Address
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Address Line | 1702 OHIO AVE
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City | LYNN HAVEN
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State | FL
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Zip | 32444-4290
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Country | US
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Telephone | 850-867-7812
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Fax | 850-747-2016
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Provider Business Mailing Address
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Address Line | 1702 OHIO AVE
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City | LYNN HAVEN
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State | FL
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Zip | 32444-4290
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Country | US
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Telephone | 850-867-7812
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Fax | 850-747-2016
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | WILLIAM RODMAN RHODES
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Credential | ARNP
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Telephone | 850-867-7812
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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