MEDICARE: HEALTHCARE MANAGEMENT SOLUTIONS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171W00000X	Contractor

General Provider Information

NPI Number	:	1649654864
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHCARE MANAGEMENT SOLUTIONS, LLC

Provider Business Mailing Address
First Line	:	4508 CAPITAL DOME DR
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32246-7457
Country	:	US
Telephone Number	:	904-465-2863
Fax Number	:

Provider Business Practice Location Address
First Line	:	4508 CAPITAL DOME DR
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32246-7457
Country	:	US
Telephone Number	:	904-465-2863
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	NELLY GONZALEZ
Credential	:
Telephone Number	:	904-465-2863

Provider Enumeration Date	:	07/17/2015
Last Update Date	:	07/17/2015

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