SANTA ROSA HMA PHYSICIAN MANAGEMENT LLC NPI 1093474637

NPI Information

  • NPI: 1093474637
  • Provider Name: SANTA ROSA HMA PHYSICIAN MANAGEMENT LLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Doing Business As: SANTA ROSA HMA PHYSICIAN MANAGEMENT LLC
  • CLIA Number: 10D2151009
  • Address: 4225 WOODBINE RD STE G
    MILTON, FL
    ZIP 32571
  • Phone: (850) 994-6575

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NPI Details

SANTA ROSA HMA PHYSICIAN MANAGEMENT LLC is a family medicine in Milton, 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. SANTA ROSA HMA PHYSICIAN MANAGEMENT LLC NPI is 1093474637. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Santa Rosa Hma Physician Management Llc.

The provider's business location address is:

4225 WOODBINE RD STE G
MILTON, FL
ZIP 32571-791
Phone: (850) 994-6575
Fax: (850) 994-5643

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

The CLIA number assigned to this NPI record is 10D2151009 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/10/2021 and was last updated on 3/16/2022.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamilyNo
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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1PENDINGMEDICAIDFLORIDA

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: 3/30/2025

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