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10D2068592 CLIA NUMBER - SHARON NICKELL- OLM MD FAMILY MEDICAL CENTER LLC

Laboratory Demographics

CLIA Number: 10D2068592

Facility Name: SHARON NICKELL- OLM MD FAMILY MEDICAL CENTER LLC

Facility Address:
2000 PREVATT STREET
EUSTIS, FL
ZIP 32726
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Facility Phone Number: 352 357-2600

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1407076052

Taxonomy: 207QH0002X - Family Medicine
A family medicine physician with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illnesses. This specialist works with an interdisciplinary hospice or palliative care team to maximize quality of life while addressing physical, psychological, social and spiritual needs of both patient and family throughout the course of the disease, through the dying process, and beyond for the family. This specialist has expertise in the assessment of patients with advanced disease; the relief of distressing symptoms; the coordination of interdisciplinary patient and family-centered care in diverse venues; the use of specialized care systems including hospice; the management of the imminently dying patient; and legal and ethical decision making in end-of-life care.

CLIA Record

Field Name Field Value
CLIA Number 10D2068592
LAB Type Physician Office
Facility Name SHARON NICKELL- OLM MD FAMILY MEDICAL CENTER LLC
Street 2000 PREVATT STREET
City EUSTIS
State FL
ZIP 32726
Phone 352 357-2600
CertificateType 4
CertificateEffectiveDate 11/7/2023
CertificateExpirationDate 11/6/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024