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Organization

SANTA ROSA HMA PHYSICIAN MANAGEMENT LLC

Active
Other names
Santa Rosa HMA Physician Management LLC
Organization subpart
No

Provider details

NPI number
Authorized official
JENNIFER L JACKSON (SR DIR ENROLLMENT & ONBOARDING)
(615) 465-3334
Entity
Organization

Contact information

Practice address
5992 BERRYHILL RD STE 203, MILTON, FL 32570-1014
(850) 626-5391
(850) 623-5388
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 465-7211
(615) 628-6877

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
374819729
FL
Enumeration date
06/09/2021
Last updated
03/16/2022
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