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HAILE MEDICAL GROUP PA NPI 1851433197


NPI Information

NPI: 1851433197
Provider Name: HAILE MEDICAL GROUP PA
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 10D0976727

Address:
4750 SW 91ST DR STE A
GAINESVILLE, FL
ZIP 32608
Phone: (352) 367-9602
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HAILE MEDICAL GROUP PA is a family medicine in Gainesville, 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. HAILE MEDICAL GROUP PA NPI is 1851433197. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4750 SW 91ST DR STE A
GAINESVILLE, FL
ZIP 32608-140
Phone: (352) 367-9602

The provider's authorized official is Nichole Osborne .
The authorized official title is Manager and has the following contact phone number (352) 367-9602.

The CLIA number assigned to this NPI record is 10D0976727 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/13/2007 and was last updated on 2/25/2009.


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
1207Q00000XFamily 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
1K0934MEDICARE PINFLORIDA

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

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