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211 Ranchera St Nw Live Oak FL 32064 | |
(386) 364-1751 | |
(386) 364-1761 |
Full Name | |
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Speciality | Clinic/Center |
Location | 211 Ranchera St Nw, Live Oak, Florida |
Authorized Official Name and Position | Anita H Rembert (C.E.O.) |
Authorized Official Contact | 3864540698 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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23476 Nw 186th Ave High Springs FL 32643-0673 Ph: (386) 454-0698 | 211 Ranchera St Nw Live Oak FL 32064 Ph: (386) 364-1751 |
NPI Number | 1124432042 |
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Provider Enumeration Date | 06/18/2014 |
Last Update Date | 01/10/2025 |
Medicare PECOS PAC ID | 2365359387 |
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Medicare Enrollment ID | O20140722001647 |
Identifier | Type | State | Issuer |
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1124432042 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Acv Community Services Ll Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10820 Marvin E Jones Blvd, Live Oak, FL 32060 Phone: 386-658-5341 | |
Horizon Pediatrics, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 611 Demorest St Se, Live Oak, FL 32064 Phone: 386-362-5437 Fax: 386-362-5440 | |