Organization
SANTA ROSA HB MEDICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA DURHAM (VP PHYSICIAN BUSINESS SERVICES)
(877) 892-9815
Entity
Organization
Contact information
Practice address
151 E REDSTONE AVE, CRESTVIEW, FL 32539-5352
(877) 892-9815
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 465-7377
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
2085N0700X
Neuroradiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
09/29/2023
Last updated
06/11/2024
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