# SANTA ROSA HMA PHYSICIAN MANAGEMENT LLC

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

## Provider details

- **NPI number:** 1558061085
- **Authorized official:** JENNIFER L JACKSON (SENIOR DIRECTOR)
- **Authorized official phone:** (615) 465-3334

## Contact information

- **Practice address:** 5804 DOGWOOD DRIVE, MILTON, FL 32570
- **Practice address phone:** (850) 626-5389
- **Mailing address:** PO BOX 689022, FRANKLIN, TN 37068-9022

## Taxonomy

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

## Other

- **Enumeration date:** 03/03/2023
- **Last updated:** 03/03/2023