Organization
LIVE OAK HMA, LLC
Active
Other names
Shands Live Oak Regional Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA LALOR (DIRECTOR/DELEGATED OFFICIAL)
(615) 925-4565
Entity
Organization
Contact information
Practice address
1100 11TH ST SW, LIVE OAK, FL 32064-3608
(386) 362-0800
(352) 733-0069
Mailing address
1100 11TH ST SW, LIVE OAK, FL 32064-3608
(386) 362-0800
(352) 733-0069
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
4314
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010179600
—
FL
01
—
CF9177
MEDICARE RAIL ROAD
FL
Enumeration date
09/21/2006
Last updated
02/22/2018
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