# LIVE OAK FAMILY PRACTICE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134892201
- **Authorized official:** MELISSA F PETERS APRN (OWNER)
- **Authorized official phone:** (386) 688-7813

## Contact information

- **Practice address:** 1304 OHIO AVE S, LIVE OAK, FL 32064-4156
- **Practice address phone:** (386) 364-0776
- **Mailing address:** 10061 COUNTY ROAD 49, LIVE OAK, FL 32060-7686
- **Mailing address phone:** (386) 688-7813

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 07/26/2021
- **Last updated:** 07/26/2021