LEGACY OF N. FL. (NPI# 1336753722) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336753722 |
| Entity Type | Organization |
| Organization Name | LEGACY OF N. FL. |
| Practice Address |
1468 Sw Main Blvd Ste 105-5 Lake City FL 32025-1115 |
| Practice Telephone | 3866230561 |
| Mailing Telephone | 3866230561 |
| Enumeration Date | 2020-09-02 |
| Last Update Date | 2020-09-09 |
| Authorized Official Name | MR. MICHAEL DUANE MINTON (OWNER) |
| Authorized Official Telephone | 3866230561 |
| Authorized Official Credential | RN EMT-P |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3416L0300X |
Ambulance Specialization: Land Transport |
Transportation Services |
| Street Address |
1468 SW MAIN BLVD STE 105-5 |
| City | LAKE CITY |
| State | FL |
| Zip Code | 32025-1115 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801438353 | Jennifer Bennett | Pharmacist | 347 Sw Main Blvd Suite 102, Lake City, FL 32025 | 2019-10-16 |
| 1700352838 | Robert J Sansouci IIi IIi | Physical Therapy Assistant | 560 Sw Mcfarlane Ave, Lake City, Fl, 32025, Lake City, FL 32025 | 2018-10-16 |
| 1316442783 | Emily Bailey | Developmental Therapist | 2126 Sw Sisters Welcome Rd, Lake City, FL 32025 | 2018-03-28 |
| 1811446370 | Michelle Hart | Behavioral Analyst | 260 S. Marion Avenue, Bldg. A, Suite 135, Lake City, FL 32025 | 2016-09-26 |
| 1922467646 | Irene Aponte Moreno | Nurse Practitioner | 440 Sw Perimeter Glen, Lake City, FL 32025 | 2016-02-23 |
| 1093186777 | Decarlos Scippio | Counselor | 619 Sw Baya Drive Suite 102, Lake City, FL 32025 | 2015-10-07 |
| 1497132476 | Jamecia Legree | Registered Nurse | 800 Sw Symphony Loop, Bldg 15 Apt 204, Lake City, FL 32025 | 2015-04-29 |
| 1306249149 | Mercy Home Assisted Living Facility LLC | Assisted Living Facility | 184 S.e. Beech Street, Lake City, FL 32025 | 2014-10-08 |
| 1598174344 | Karen Mcdonald | Developmental Therapist | 4523 Se County Road 252, Lake City, FL 32025 | 2014-08-06 |
| 1275944126 | Mohammad Ali Faisal Mdpa | Specialist | 1283 Sw State Rd 47, Ste 104, Lake City, FL 32025 | 2014-05-14 |
| Find all providers in zip 32025 | ||||
| Taxonomy Code | 3416L0300X |
| Grouping | Transportation Services |
| Classification | Ambulance |
| Specialization | Land Transport |
| Definition to come... |
| Notes: [1/1/2005: title modified] |
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| 1194885483 | City of Lake City | Ambulance | 209 S High St, Lake City, MN 55041-1638 | 2006-12-10 |
| 1376624171 | First Choice Ambulance, Inc. | Ambulance | 191 E Loop Rd, Lake City, SC 29560-2172 | 2006-10-18 |
| 1164539284 | Lifeline Regional Ambulance, Inc. | Ambulance | 239 N Acline St, Lake City, SC 29560-2159 | 2006-08-24 |
| 1407877533 | Zander's Transport Services | Ambulance | 324 Moore St, Lake City, SC 29560-2523 | 2006-07-22 |
| 1306823612 | County of Hinsdale | Ambulance | 700 Henson St, Lake City, CO 81235 | 2005-12-28 |
| 1578555801 | Columbia County Emergency Medical Services | Ambulance | 263 Nw Lake City Ave, Lake City, FL 32055-4820 | 2005-08-23 |
| 1063967842 | Timothy Mcknight | Ambulance | 5499 Jonesboro Rd, Lake City, GA 30260-3553 | 2016-08-22 |
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| 1194247379 | Global Reach Medical, LLC | Ambulance | 126 Sand Pine Dr, Jupiter, FL 33477-9676 | 2017-07-10 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.