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General NPI Number Information
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NPI Number | 1437692688
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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 | 11/21/2016
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Last Update Date | 12/31/2025
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Provider Practice Location Address
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Address Line | 10435 SE 170TH PL
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City | SUMMERFIELD
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State | FL
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Zip | 34491-8998
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Country | US
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Telephone | 352-233-4393
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Fax |
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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 | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number |
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License Number State |
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