Healthcare Provider Details
I. General information
NPI: 1508669607
Provider Name (Legal Business Name): ALLEO HEALTH OF FLORIDA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/01/2025
Last Update Date: 04/22/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
501 RIVERSIDE AVE STE 904
JACKSONVILLE FL
32202-4940
US
IV. Provider business mailing address
500 FAULCONER DR STE 200
CHARLOTTESVILLE VA
22903-5089
US
V. Phone/Fax
- Phone: 434-977-9711
- Fax: 434-235-4142
- Phone: 434-977-9711
- Fax: 434-235-4142
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QH0002X |
| Taxonomy | Hospice and Palliative Medicine (Family Medicine) Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0002X |
| Taxonomy | Hospice and Palliative Medicine (Internal Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JESSE
R
MOORE
Title or Position: CHIEF ADMINISTRATIVE OFFICER
Credential:
Phone: 857-331-6271