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Organization

LIVE OAK FAMILY PRACTICE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MELISSA F PETERS APRN (OWNER)
(386) 688-7813
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary

Other

Enumeration date
07/26/2021
Last updated
07/26/2021
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