Organization
LIVE OAK HMA, LLC
Active
Other names
Shands Live Oak Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA LALOR (DIRECTOR/DELEGATED OFFICIAL)
(615) 925-4565
Entity
Organization
Contact information
Practice address
1426 CANYON AVE NE, UNIT B, LIVE OAK, FL 32064-4832
(386) 208-0537
Mailing address
1426 CANYON AVE NE, UNIT B, LIVE OAK, FL 32064-4832
(386) 208-0537
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
4314
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
660120100
—
FL
05
—
660120101
—
FL
01
—
CE9137
MEDICARE RAIL ROAD
FL
Enumeration date
10/05/2006
Last updated
02/23/2018
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us