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General NPI Number Information
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NPI Number | 1184723777
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Entity Type | Organization
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Legal Business Name | SHANDS TEACHING HOSPITAL AND CLINICS, INC.
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 3951 NW 48TH TER STE 101
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City | GAINESVILLE
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State | FL
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Zip | 32606-7229
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Country | US
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Telephone | 352-265-5230
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Fax | 352-265-5231
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Provider Business Mailing Address
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Address Line | PO BOX 100303
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City | GAINESVILLE
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State | FL
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Zip | 32610-0303
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Country | US
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Telephone | 352-627-9045
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. MICHAEL D. HOLMES
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Credential |
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Telephone | 352-733-1500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 4286
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License Number State | FL
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