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General NPI Number Information
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NPI Number | 1376899575
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Entity Type | Organization
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Legal Business Name | PASAME LLC
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Dates
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Enumeration Date | 07/25/2012
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Last Update Date | 07/25/2012
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Provider Practice Location Address
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Address Line | 6817 SOUTHPOINT PKWY SUITE 1704
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City | JACKSONVILLE
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State | FL
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Zip | 32216-6282
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Country | US
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Telephone | 855-424-3476
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Fax | 800-388-0270
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Provider Business Mailing Address
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Address Line | 6817 SOUTHPOINT PKWY SUITE 1704
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City | JACKSONVILLE
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State | FL
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Zip | 32216-6282
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Country | US
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Telephone | 855-424-3476
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Fax | 800-388-0270
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Authorized Official
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Title or Position | MD/OWNER
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Name | HALE E HEDLEY
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Credential | MD
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Telephone | 855-424-3476
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | ME94099
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License Number State | FL
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