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Organization
SANTA ROSA HMA PHYSICIAN MANAGEMENT LLC
Active
Organization
SANTA ROSA HMA PHYSICIAN MANAGEMENT LLC
Active
Other names
Santa Rosa HMA Physician Management LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER L JACKSON (SR DIR PROV ENROLLMENT & ONBOARDING)
(615) 465-3334
Entity
Organization
Contact information
Practice address
7456 NAVARRE PKWY, NAVARRE, FL 32566-8192
(850) 626-5459
(855) 322-1928
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 465-7211
(615) 628-6877
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
208600000X
Surgery Physician
—
—
363A00000X
Physician Assistant
—
—
363LA2100X
Acute Care Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
374819738
—
FL
Enumeration date
07/01/2021
Last updated
03/16/2022
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