Organization
BROOKSVILLE HMA PHYSICIAN MANAGEMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER L JACKSON (SR. DIRECTOR PROVIDER ENROLLMENT)
(615) 465-3334
Entity
Organization
Contact information
Practice address
1669 SE US HIGHWAY 19, CRYSTAL RIVER, FL 34429-4849
(352) 563-2807
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 465-7000
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
08/16/2022
Last updated
08/16/2022
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