| Palms Medical Group | |
|
211 Ranchera St Nw Live Oak FL 32064 | |
| (386) 364-1751 | |
| (386) 364-1761 |
| Full Name | Palms Medical Group |
|---|---|
| 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 |
|---|---|
| Palms Medical Group 23476 Nw 186th Ave High Springs FL 32643-0673 Ph: (386) 454-0698 | Palms Medical Group 211 Ranchera St Nw Live Oak FL 32064 Ph: (386) 364-1751 |
| NPI Number | 1124432042 |
|---|---|
| Provider Enumeration Date | 06/18/2014 |
| Last Update Date | 01/10/2025 |
| Certification Date | 01/10/2025 |
| Medicare PECOS PAC ID | 2365359387 |
|---|---|
| Medicare Enrollment ID | O20140722001647 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124432042 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | () | Primary |
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