Provider Demographics
NPI:1184366700
Name:NORTH FLORIDA SOUTH GEORGIA VETERANS HEALTHCARE SYSTEM
Entity type:Organization
Organization Name:NORTH FLORIDA SOUTH GEORGIA VETERANS HEALTHCARE SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MH SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSALIND
Authorized Official - Middle Name:LAURIE
Authorized Official - Last Name:LARRY
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:352-369-3320
Mailing Address - Street 1:4826 SW 49TH RD
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-6299
Mailing Address - Country:US
Mailing Address - Phone:352-369-3320
Mailing Address - Fax:352-384-7451
Practice Address - Street 1:4826 SW 49TH RD
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-6299
Practice Address - Country:US
Practice Address - Phone:352-369-3320
Practice Address - Fax:352-384-7451
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DEPARTMENT OF VETERANS AFFAIRS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-04-13
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center