Organization
SANTA ROSA HB MEDICAL SERVICES LLC
Active
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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