Healthcare Provider Details

I. General information

NPI: 1396792818
Provider Name (Legal Business Name): ALLEVIA MEDICAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14482 CHERRY LAKE DR E
JACKSONVILLE FL
32258-5178
US

IV. Provider business mailing address

PO BOX 600888
JACKSONVILLE FL
32260-0888
US

V. Phone/Fax

Practice location:
  • Phone: 904-371-2958
  • Fax: 866-808-7982
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: ALBERT RAMSAY
Title or Position: CHIEF FINNCIAL OFFICER
Credential:
Phone: 904-371-2958