Suwannee Emergency Group LLC

NPI #1669917472 in Live Oak, Florida

Provider Information

NPI Number: 1669917472
Entity Type: Organization
Organization Name: Suwannee Emergency Group LLC
Primary Specialty: Emergency Medicine
Enumeration Date: Jan 3, 2017
Last Updated: Jan 3, 2017

Practice Location

Address: 1100 11TH ST SW
City: Live Oak
State: Florida
ZIP Code: 32064-3608
Phone: (386) 362-0800

Authorized Official

Name: LISHA FALK
Title: VP OF CONTRACTING
Phone: (337) 354-1221

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X
Nurse Practitioner	363L00000X
Emergency Medicine	207P00000X	Primary

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