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BROOKSVILLE HMA PHYSICIAN MANAGEMENT LLC NPI 1063089332


NPI Information

NPI: 1063089332
Provider Name: BROOKSVILLE HMA PHYSICIAN MANAGEMENT LLC

Doing Business As: BROOKSVILLE HMA PHYSICIAN MANAGEMENT LLC

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 10D0869749

Address:
11329 CORTEZ BLVD
BROOKSVILLE, FL
ZIP 34613
Phone: (352) 596-5052
Get Directions

BROOKSVILLE HMA PHYSICIAN MANAGEMENT LLC is a family medicine in Brooksville, FL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. BROOKSVILLE HMA PHYSICIAN MANAGEMENT LLC NPI is 1063089332. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Brooksville Hma Physician Management Llc.

The provider's business location address is:

11329 CORTEZ BLVD
BROOKSVILLE, FL
ZIP 34613-407
Phone: (352) 596-5052
Fax: (352) 596-5244

The provider's authorized official is Jennifer L Jackson .
The authorized official title is Sr Dir Prov Enrollment & Onboarding and has the following contact phone number (615) 465-3334.

The CLIA number assigned to this NPI record is 10D0869749 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/7/2021 and was last updated on 3/7/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363L00000XNurse PractitionerNo
2207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1002631009MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.