| Legacy Family Healthcare Inc | |
|
974 Sunny Stroll Dr Middleburg FL 32068-3597 | |
| (850) 319-1491 | |
| Not Available |
| Full Name | Legacy Family Healthcare Inc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 974 Sunny Stroll Dr, Middleburg, Florida |
| Authorized Official Name and Position | Christin Delaney (OWNER) |
| Authorized Official Contact | 8503191491 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Family Healthcare Inc 974 Sunny Stroll Dr Middleburg FL 32068-3597 Ph: () - | Legacy Family Healthcare Inc 974 Sunny Stroll Dr Middleburg FL 32068-3597 Ph: (850) 319-1491 |
| NPI Number | 1245988302 |
|---|---|
| Provider Enumeration Date | 03/16/2022 |
| Last Update Date | 03/18/2022 |
| Medicare PECOS PAC ID | 3678969821 |
|---|---|
| Medicare Enrollment ID | O20220415000333 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245988302 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Primary |
| Provider Name | Brenda J Luna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376814483 PECOS PAC ID: 2961498993 Enrollment ID: I20040423000644 |
| Provider Name | Susan Wolfe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336689470 PECOS PAC ID: 8123386968 Enrollment ID: I20171227001680 |
| Provider Name | Larry Robert Little |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134504079 PECOS PAC ID: 2961767363 Enrollment ID: I20180606002252 |
| Provider Name | Shannon J O Brien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245614114 PECOS PAC ID: 6305147976 Enrollment ID: I20191111000363 |
| Provider Name | Christin Delaney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023616083 PECOS PAC ID: 9335544303 Enrollment ID: I20210830001709 |
| Provider Name | Megan Elizabeth Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154020022 PECOS PAC ID: 2466827175 Enrollment ID: I20230412000118 |
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