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Organization

SANTA ROSA HMA PHYSICIAN MANAGEMENT LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JENNIFER L JACKSON (SENIOR DIRECTOR)
(615) 465-3334
Entity
Organization

Contact information

Practice address
5595 WOODBINE RD, PACE, FL 32571
(850) 981-7746
(850) 981-7743
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
207V00000X
Obstetrics & Gynecology Physician
207X00000X
Orthopaedic Surgery Physician
208600000X
Surgery Physician
Primary

Other

Enumeration date
03/03/2023
Last updated
03/03/2023
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