| Healthcare Extraordinare, Llc | |
|
3154 Highland Grove Dr Orange Park FL 32065-6855 | |
| (904) 613-6974 | |
| (904) 375-2012 |
| Full Name | Healthcare Extraordinare, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3154 Highland Grove Dr, Orange Park, Florida |
| Authorized Official Name and Position | Tana Robinson (DNP/APRN) |
| Authorized Official Contact | 9046133974 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthcare Extraordinare, Llc 3154 Highland Grove Dr Orange Park FL 32065-6855 Ph: (904) 613-6974 | Healthcare Extraordinare, Llc 3154 Highland Grove Dr Orange Park FL 32065-6855 Ph: (904) 613-6974 |
| NPI Number | 1780273474 |
|---|---|
| Provider Enumeration Date | 01/16/2021 |
| Last Update Date | 01/16/2021 |
| Medicare PECOS PAC ID | 4385044130 |
|---|---|
| Medicare Enrollment ID | O20210615003500 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780273474 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Tana S Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992953863 PECOS PAC ID: 1557427986 Enrollment ID: I20090310000072 |
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