| Palms Medical Group | |
|
200 Sw 62nd Blvd Gainesville FL 32607-6030 | |
| (352) 376-8211 | |
| (352) 373-7594 |
| Full Name | Palms Medical Group |
|---|---|
| Speciality | Clinic/Center |
| Location | 200 Sw 62nd Blvd, Gainesville, Florida |
| Authorized Official Name and Position | Anita H. Rembert (CEO) |
| Authorized Official Contact | 3864540698 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Palms Medical Group 23343 Nw County Road 236 High Springs FL 32643-9669 Ph: (386) 454-0698 | Palms Medical Group 200 Sw 62nd Blvd Gainesville FL 32607-6030 Ph: (352) 376-8211 |
| NPI Number | 1740513928 |
|---|---|
| Provider Enumeration Date | 09/07/2009 |
| Last Update Date | 10/19/2021 |
| Medicare PECOS PAC ID | 2365359387 |
|---|---|
| Medicare Enrollment ID | O20110920000542 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740513928 | NPI | - | NPPES |
| 029506013 | Medicaid | FL | |
| 77513A | Other | FL | FIRST COAST PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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