Provider Demographics
NPI:1689812109
Name:HMA/SOLANTIC JOINT VENTURE, LLC
Entity Type:Organization
Organization Name:HMA/SOLANTIC JOINT VENTURE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:WEBSTER
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLINKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-550-0821
Mailing Address - Street 1:10151 DEERWOOD PARK BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-0566
Mailing Address - Country:US
Mailing Address - Phone:904-854-1545
Mailing Address - Fax:
Practice Address - Street 1:1820 58TH AVE.
Practice Address - Street 2:UNIT 110
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32966
Practice Address - Country:US
Practice Address - Phone:772-257-3200
Practice Address - Fax:772-257-0187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-22
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCN189AMedicare PIN