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General NPI Number Information
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NPI Number | 1366301368
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Entity Type | Organization
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Legal Business Name | LIV SPECIALTY CARE FL, PA
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Dates
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Enumeration Date | 01/16/2026
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Last Update Date | 01/16/2026
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Provider Practice Location Address
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Address Line | 410 BLANDING BLVD STE 6B
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City | ORANGE PARK
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State | FL
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Zip | 32073-5065
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Country | US
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Telephone | 904-775-7238
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Fax | 904-913-4304
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Provider Business Mailing Address
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Address Line | 4900 CENTENNIAL BLVD STE 300
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City | NASHVILLE
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State | TN
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Zip | 37209-1105
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Country | US
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Telephone | 844-509-1404
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Fax | 844-278-8635
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Authorized Official
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Title or Position | CEO
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Name | WOODRUFF HALL BAUM
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Credential |
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Telephone | 646-568-0193
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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