Eagle Medical Management, Inc.

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

License

679680096 Issued in FL

Legal business name

EAGLE MEDICAL MANAGEMENT, INC.

Practice address

10252 SE US Highway 441
Belleview, FL 34420-6819

Phone

(352) 245-7245

Fax

(352) 245-6317

NPI assigned

May 22, 2008

Organization subpart

No

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

Authorized official

Name

Jena Maria Woodyard

Title

President

Phone

(352) 427-4438

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211414400000",
    "number": "1518124957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10252 SE US HIGHWAY 441",
            "city": "BELLEVIEW",
            "state": "FL",
            "postal_code": "344206819",
            "telephone_number": "352-245-7245",
            "fax_number": "352-245-6317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10252 SE US HIGHWAY 441",
            "city": "BELLEVIEW",
            "state": "FL",
            "postal_code": "344206819",
            "telephone_number": "352-245-7245",
            "fax_number": "352-245-6317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE MEDICAL MANAGEMENT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-22",
        "last_updated": "2008-05-22",
        "status": "A",
        "authorized_official_last_name": "WOODYARD",
        "authorized_official_first_name": "JENA",
        "authorized_official_middle_name": "MARIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-427-4438"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "FL",
            "license": "679680096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "679680096",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "679680098",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary L Doyle
• Miranda May Draper
• Regina Marie Dubois-Rodabaugh
• Denise Dunn
• Eafr Gallo Enterprise Corporation
• Abbagail Easter, DC
• Sharnise Edwards
• Makayla Evans
• Express Care of Belleview, LLC
• Richard W Falkenberg, M.D.

• Developmentally Disabled Services Day Training Agency in Belleview, FL
• Providers in Belleview, FL by specialty
• Developmentally Disabled Services Day Training Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.