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CRYSTAL RIVER HMA PHYSICIAN MANAGEMENT LLC NPI 1942960786


NPI Information

NPI: 1942960786
Provider Name: CRYSTAL RIVER HMA PHYSICIAN MANAGEMENT LLC

Doing Business As: CRYSTAL RIVER HMA PHYSICIAN MANAGEMENT LLC

Classification: Surgery - 208600000X
Entity Type: Organization

CLIA Number: 10D2280556

Address:
3475 S SUNCOAST BLVD
HOMOSASSA, FL
ZIP 34448
Phone: (352) 765-2010
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CRYSTAL RIVER HMA PHYSICIAN MANAGEMENT LLC is a surgery in Homosassa, FL. The provider is a general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. CRYSTAL RIVER HMA PHYSICIAN MANAGEMENT LLC NPI is 1942960786. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Crystal River Hma Physician Management Llc.

The provider's business location address is:

3475 S SUNCOAST BLVD
HOMOSASSA, FL
ZIP 34448-322
Phone: (352) 765-2010
Fax: (352) 765-2017

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 10D2280556 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/21/2021 and was last updated on 3/14/2022.


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
1133V00000XDietitian, RegisteredNo
2208600000XSurgeryYes

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: 5/5/2024

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