=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477424943
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SHANDS TEACHING HOSPITAL AND CLINICS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/16/2025
-----------------------------------------------------
Last Update Date | 12/31/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14359 SW 2ND PL STE 4
-----------------------------------------------------
City | NEWBERRY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32669-6376
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-265-2777
-----------------------------------------------------
Fax | 352-627-5384
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 100303
-----------------------------------------------------
City | GAINESVILLE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32610-0303
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-627-9045
-----------------------------------------------------
Fax | 352-627-9049
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | MICHAEL DAVID HOLMES
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 352-733-1500
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 282N00000X
-----------------------------------------------------
Taxonomy Name | General Acute Care Hospital
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------