Organization
PHYSICIAN PARTNERS NETWORK PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOUISE ELDRIDGE (OFFICE MANAGER)
(352) 796-9990
Entity
Organization
Contact information
Practice address
605 LAMAR AVE, BROOKSVILLE, FL 34601-3211
(352) 796-9990
(352) 796-2226
Mailing address
605 LAMAR AVE, BROOKSVILLE, FL 34601-3211
(352) 796-9990
(352) 796-2226
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
—
FL
261QR1300X
Rural Health Clinic/Center
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
251473700
—
FL
01
—
40952
BLUE CROSS BLUE SHIELD
FL
05
—
660024700
—
FL
01
—
CD8188
RAILROAD MEDICARE
FL
Enumeration date
06/07/2006
Last updated
06/03/2008
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