Organization
KEY WEST HMA PHYSICIAN MANAGEMENT LLC
Active
Organization
KEY WEST HMA PHYSICIAN MANAGEMENT LLC
Active
Other names
Key West HMA Physician Management LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER L JACKSON (SR. DR PROV ENROLLMENT & ONBOARDING)
(615) 465-3334
Entity
Organization
Contact information
Practice address
1111 12TH ST STE 210, KEY WEST, FL 33040-3001
(305) 292-5823
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 465-7211
(615) 628-6877
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RG0100X
Gastroenterology Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
—
207XX0801X
Orthopaedic Trauma Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
363LA2100X
Acute Care Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
FL
Enumeration date
08/24/2021
Last updated
03/16/2022
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