| Live Oak Hma Medical Group, Llc | |
|
1116 11th St Sw Live Oak FL 32064-3608 | |
| (239) 598-3131 | |
| (239) 592-0438 |
| Full Name | Live Oak Hma Medical Group, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1116 11th St Sw, Live Oak, Florida |
| Authorized Official Name and Position | Michael L Gingras (VICE PRESIDENT) |
| Authorized Official Contact | 2395983131 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Live Oak Hma Medical Group, Llc 5811 Pelican Bay Blvd Suite 500 Naples FL 34108-2733 Ph: (239) 598-3131 | Live Oak Hma Medical Group, Llc 1116 11th St Sw Live Oak FL 32064-3608 Ph: (239) 598-3131 |
| NPI Number | 1740509991 |
|---|---|
| Provider Enumeration Date | 05/27/2010 |
| Last Update Date | 11/26/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740509991 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
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