Organization
EAGLE MEDICAL MANAGEMENT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENA MARIA WOODYARD (PRESIDENT)
(352) 427-4438
Entity
Organization
Contact information
Practice address
10252 SE US HIGHWAY 441, BELLEVIEW, FL 34420-6819
(352) 245-7245
(352) 245-6317
Mailing address
10252 SE US HIGHWAY 441, BELLEVIEW, FL 34420-6819
(352) 245-7245
(352) 245-6317
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
679680096
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
679680096
—
FL
05
—
679680098
—
FL
Enumeration date
05/22/2008
Last updated
05/22/2008
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