Provider Demographics
NPI:1720363971
Name:HMA
Entity Type:Organization
Organization Name:HMA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ARNP
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SCHAEFFER
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:239-368-1808
Mailing Address - Street 1:60 WESTMINSTER ST N
Mailing Address - Street 2:SUITE A
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33936-6518
Mailing Address - Country:US
Mailing Address - Phone:239-368-1808
Mailing Address - Fax:239-368-0657
Practice Address - Street 1:60 WESTMINSTER ST N
Practice Address - Street 2:SUITE A
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33936-6518
Practice Address - Country:US
Practice Address - Phone:239-368-1808
Practice Address - Fax:239-368-0657
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LEHIGH MEDICAL GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-10-19
Last Update Date:2011-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9226870363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty