| Key West Hma Physician Management Llc | |
|
1200 Kennedy Dr Ste 1031 Key West FL 33040-4023 | |
| (305) 292-5877 | |
| (305) 292-5862 |
| Full Name | Key West Hma Physician Management Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 1200 Kennedy Dr Ste 1031, Key West, Florida |
| Authorized Official Name and Position | Jennifer L Jackson (SR DIR PROV ENROLLMENT & ONBOARDING) |
| Authorized Official Contact | 6154653334 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Key West Hma Physician Management Llc Po Box 689022 Franklin TN 37068-9022 Ph: (615) 465-7211 | Key West Hma Physician Management Llc 1200 Kennedy Dr Ste 1031 Key West FL 33040-4023 Ph: (305) 292-5877 |
| NPI Number | 1093388399 |
|---|---|
| Provider Enumeration Date | 07/23/2021 |
| Last Update Date | 03/16/2022 |
| Certification Date | 03/16/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093388399 | NPI | - | NPPES |
| PENDING | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Secondary |
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