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Organization

KEY WEST HMA PHYSICIAN MANAGEMENT LLC

Active
Other names
Keys Medical Group
Organization subpart
No

Provider details

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

Contact information

Practice address
1111 12TH ST STE 205, KEY WEST, FL 33040-3001
(615) 465-7211
(615) 628-6877
Mailing address
1111 12TH ST STE 205, KEY WEST, FL 33040-3001
(615) 465-7211
(615) 628-6877

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
2084P0800X
Psychiatry Physician
Primary
251S00000X
Community/Behavioral Health Agency
363LP0808X
Psychiatric/Mental Health Nurse Practitioner

Other

Enumeration date
04/20/2023
Last updated
06/16/2023
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