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General NPI Number Information
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NPI Number | 1326044793
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Entity Type | Organization
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Legal Business Name | COUNTY OF HERNANDO BOARD OF COUNTY COMMISSIONERS
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Dates
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Enumeration Date | 06/21/2005
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Last Update Date | 03/24/2021
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Provider Practice Location Address
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Address Line | 60 VETERANS AVE
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City | BROOKSVILLE
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State | FL
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Zip | 34601
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Country | US
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Telephone | 352-540-4353
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Fax | 352-540-4355
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Provider Business Mailing Address
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Address Line | 15470 FLIGHT PATH DR
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City | BROOKSVILLE
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State | FL
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Zip | 34604-6823
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Country | US
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Telephone | 352-540-4353
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Fax | 352-540-4355
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Authorized Official
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Title or Position | CHIEF
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Name | MIKE NICKERSON
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Credential |
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Telephone | 352-540-4353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 2502
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License Number State | FL
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