Magnolia Adult

LBN: Magnolia Adult
Magnolia Adult is an health care organization with primary practice located at 1140 Sw Bascom Norris Dr Ste 105 , Lake City FL 32025-1329. 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 (386) 755-3300, or through Lee, Ira D via phone (386) 755-3300.

Contact Information

Primary practice address
1140 Sw Bascom Norris Dr Ste 105 Lake City FL 32025-1329
Phone: (386) 755-3300
Fax: (386) 755-8595
Website:
Map and Directions
Authorized official contact:
Name: Lee, Ira D ARNP-C
Phone: (386) 755-3300

Health care specialties

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

Profile Details

NPI number 1033477567
LBN Legal business name Magnolia Adult
DBA Doing business as
Authorized official Lee, Ira D ARNP-C
Entity Organization
Organization subpart 1 No
Enumeration date May 3rd, 2012
Last updated May 3rd, 2012 - about 14 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 1033477567 NPPES
Florida MEDICAID 305351200

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