MEDICARE: AVECINA MEDICAL, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332900000X	Non-Pharmacy Dispensing Site		FL

General Provider Information

NPI Number	:	1700275310
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AVECINA MEDICAL, PA

Provider Business Mailing Address
First Line	:	9580 APPLECROSS RD
Second Line	:	106
City	:	JACKSONVILLE
State	:	FL
Zip	:	32222-5845
Country	:	US
Telephone Number	:	904-778-9180
Fax Number	:	904-778-9740

Provider Business Practice Location Address
First Line	:	1633 RACE TRACK RD
Second Line	:	101
City	:	SAINT JOHNS
State	:	FL
Zip	:	32259-3234
Country	:	US
Telephone Number	:	904-230-6988
Fax Number	:	904-342-4028

Authorized Official
Title or Position	:	OWNER
Name	:	SAMAN SOLEYMANI
Credential	:
Telephone Number	:	904-230-6988

Provider Enumeration Date	:	01/20/2015
Last Update Date	:	07/29/2024

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Directions to “AVECINA MEDICAL, PA ” Practice Location

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