| Brooksville Hma Physician Management Llc | |
|
11329 Cortez Blvd Brooksville FL 34613-5407 | |
| (352) 596-5052 | |
| (352) 596-5244 |
| Full Name | Brooksville Hma Physician Management Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 11329 Cortez Blvd, Brooksville, Florida |
| Authorized Official Name and Position | Jennifer L Jackson (SR DIR PROV ENROLLMENT & ONBOARDING) |
| Authorized Official Contact | 6154653334 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brooksville Hma Physician Management Llc Po Box 689022 Franklin TN 37068-9022 Ph: (615) 465-7211 | Brooksville Hma Physician Management Llc 11329 Cortez Blvd Brooksville FL 34613-5407 Ph: (352) 596-5052 |
| NPI Number | 1063089332 |
|---|---|
| Provider Enumeration Date | 06/07/2021 |
| Last Update Date | 03/07/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063089332 | NPI | - | NPPES |
| 002631009 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
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