Provider Demographics
NPI:1861677064
Name:SHC MEDICAL PARTNERS OF FLORIDA, LLC
Entity type:Organization
Organization Name:SHC MEDICAL PARTNERS OF FLORIDA, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:S
Authorized Official - Last Name:PEMBERTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-394-2100
Mailing Address - Street 1:805 N WHITTINGTON PKWY STE 400
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-7102
Mailing Address - Country:US
Mailing Address - Phone:502-394-2100
Mailing Address - Fax:502-568-7135
Practice Address - Street 1:4400 BAYOU BLVD STE 54A
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-1909
Practice Address - Country:US
Practice Address - Phone:800-807-6555
Practice Address - Fax:855-316-2999
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHC MEDICAL PARTNERS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-07
Last Update Date:2025-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAJ398AMedicare UPIN
FLAJ398Medicare UPIN