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General NPI Number Information
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NPI Number | 1689812109
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Entity Type | Organization
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Legal Business Name | HMA/SOLANTIC JOINT VENTURE, LLC
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Dates
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Enumeration Date | 01/22/2009
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Last Update Date | 11/02/2023
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Provider Practice Location Address
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Address Line | 1820 58TH AVE. UNIT 110
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City | VERO BEACH
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State | FL
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Zip | 32966
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Country | US
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Telephone | 772-257-3200
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Fax | 772-257-0187
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Provider Business Mailing Address
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Address Line | 10151 DEERWOOD PARK BLVD STE 200
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City | JACKSONVILLE
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State | FL
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Zip | 32256-0566
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Country | US
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Telephone | 904-854-1545
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | WEBSTER GOLINKIN
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Credential |
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Telephone | 919-550-0821
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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