| Shands Teaching Hospital And Clinics, Inc. | |
|
922 E Call St Starke FL 32091-3616 | |
| (904) 368-2300 | |
| (352) 373-3006 |
| Full Name | Shands Teaching Hospital And Clinics, Inc. |
|---|---|
| Speciality | Clinic/center |
| Location | 922 E Call St, Starke, Florida |
| Authorized Official Name and Position | James Kelly (CEO) |
| Authorized Official Contact | 3527331500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shands Teaching Hospital And Clinics, Inc. Po Box 100345 Gainesville FL 32610-0345 Ph: (352) 627-9045 | Shands Teaching Hospital And Clinics, Inc. 922 E Call St Starke FL 32091-3616 Ph: (904) 368-2300 |
| NPI Number | 1578659306 |
|---|---|
| Provider Enumeration Date | 10/05/2006 |
| Last Update Date | 11/22/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578659306 | NPI | - | NPPES |
| 257857300 | Medicaid | FL | |
| CD2952 | Other | FL | MEDICARE RAIL ROAD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 4267 (Florida) | Primary |
| 261QR0200X | Clinic/center - Radiology | 4267 (Florida) | Secondary |
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Shands Medical Group Of Starke Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1550 S Water St, Starke, FL 32091 Phone: 904-368-2343 Fax: 904-368-2484 | |
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