Magnolia Adult

LBN: Magnolia Adult
Magnolia Adult is an health care organization with primary practice located at 1211 Sw Bascom Norris Dr Ste 201 , Lake City FL 32025-4916. The organization recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as the primary health care specialty. Magnolia Adult can be contacted via phone (375) 755-3300, or through Lee, Ira D via phone (386) 755-3300.

Contact Information

Primary practice address
1211 Sw Bascom Norris Dr Ste 201 Lake City FL 32025-4916
Phone: (375) 755-3300
Fax: (386) 755-8595
Website:
Map and Directions
Authorized official contact:
Name: Lee, Ira D ARNP
Phone: (386) 755-3300

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X ARNP3091702 Florida

Profile Details

NPI number 1841611407
LBN Legal business name Magnolia Adult
DBA Doing business as
Authorized official Lee, Ira D ARNP
Entity Organization
Organization subpart 1 No
Enumeration date Dec 30th, 2013
Last updated Dec 30th, 2013 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841611407 NPPES
Florida Other Y02HU BLUE CROSS BLUE SHIELD

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