| Shands Teaching Hospital And Clinics, Inc. | |
|
3951 Nw 48th Ter Ste 101 Gainesville FL 32606-7229 | |
| (352) 265-5230 | |
| (352) 265-5231 |
| Full Name | Shands Teaching Hospital And Clinics, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 3951 Nw 48th Ter, Gainesville, Florida |
| Authorized Official Name and Position | James Kelly (CEO) |
| Authorized Official Contact | 3527331500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shands Teaching Hospital And Clinics, Inc. Po Box 100345 Gainesville FL 32610-0172 Ph: (352) 627-9045 | Shands Teaching Hospital And Clinics, Inc. 3951 Nw 48th Ter Ste 101 Gainesville FL 32606-7229 Ph: (352) 265-5230 |
| NPI Number | 1184723777 |
|---|---|
| Provider Enumeration Date | 09/21/2006 |
| Last Update Date | 11/22/2022 |
| Medicare PECOS PAC ID | 2163336504 |
|---|---|
| Medicare Enrollment ID | O20040730000726 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184723777 | NPI | - | NPPES |
| 378448700 | Medicaid | FL | |
| CH9176 | Other | FL | MEDICARE RAIL ROAD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 4286 (Florida) | Primary |
| Provider Name | Catherine Mary Blackband |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902820772 PECOS PAC ID: 9032189527 Enrollment ID: I20040730000759 |
| Provider Name | Nicole Provost |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336164276 PECOS PAC ID: 7113119140 Enrollment ID: I20101008001139 |
| Provider Name | Natalia Burcsi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548497415 PECOS PAC ID: 9032354154 Enrollment ID: I20131016000705 |
| Provider Name | Loumarie L Andrews |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487914040 PECOS PAC ID: 3870728074 Enrollment ID: I20150901000053 |
| Provider Name | Vanessa Billingsley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063076420 PECOS PAC ID: 4284963877 Enrollment ID: I20220711003317 |
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