Organization
WESTSIDE SAMARITANS CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROY TAYLOR KLOSSNER MD (DIRECTOR)
(352) 333-7700
Entity
Organization
Contact information
Practice address
10000 W NEWBERRY RD, GAINESVILLE, FL 32606-5544
(352) 333-7700
(352) 333-9009
Mailing address
10000 W NEWBERRY RD, GAINESVILLE, FL 32606-5544
(352) 333-7700
(352) 333-9009
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
—
FL
261QM1300X
Multi-Specialty Clinic/Center
Primary
N12000000613-VHCPP
FL
Other
Enumeration date
05/23/2012
Last updated
12/04/2013
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