1396616876 NPI number — SHANDS TEACHING HOSPITAL AND CLINICS, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396616876 NPI number — SHANDS TEACHING HOSPITAL AND CLINICS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SHANDS TEACHING HOSPITAL AND CLINICS, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396616876
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/06/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 100303
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GAINESVILLE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32610-0303
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
352-627-9045
Provider Business Mailing Address Fax Number:
352-627-9049

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5001 CELEBRATION POINTE AVE STE 310
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GAINESVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32608-5083
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-265-7575
Provider Business Practice Location Address Fax Number:
352-627-5383
Provider Enumeration Date:
09/16/2025

Additional Information

Authorized Official

Authorized Official Last Name:
HOLMES
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
DAVID
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
352-733-1500

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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