Active NPI
Legacy of N. FL.
- Land Ambulance
- Lake City, FL
National Provider Identifier
1336753722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210122000937 | FL | Part B Supplier - Ambulance Service Supplier | 1850705492 | Practice locations: Lake City, FL |
National Provider Directory
National Provider DirectoryLocations
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.