Organization Active NPI

Legacy of N. FL.

  • Land Ambulance
  • Lake City, FL
National Provider Identifier
1336753722
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
LEGACY OF N. FL.
Practice address
165 NW Open CT
Lake City, FL 32055-7191
Phone
(386) 243-0074
Fax
(386) 243-3876
NPI assigned
Sep 2, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michael Duane Minton
Title
Owner
Phone
(386) 243-0074

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X Primary

Addresses

Primary practice location

165 NW Open CT
Lake City, FL 32055-7191

Mailing address

1468 SW Main Blvd Ste 105-5
Lake City, FL 32025-1115
Phone (386) 243-0074

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210122000937 FL Part B Supplier - Ambulance Service Supplier 1850705492 Practice locations: Lake City, FL

National Provider Directory

National Provider Directory

Locations

1468 SW Main Blvd
Ste 1055
Lake City, FL 32025

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1599004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785110400000",
    "number": "1336753722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1468 SW MAIN BLVD STE 105-5",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320251115",
            "telephone_number": "386-243-0074",
            "fax_number": "386-243-3876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 NW OPEN CT",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320557191",
            "telephone_number": "386-243-0074",
            "fax_number": "386-243-3876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY OF N. FL.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-02",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A",
        "authorized_official_last_name": "MINTON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "DUANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-243-0074"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.