Healthcare Provider Details

I. General information

NPI: 1962200717
Provider Name (Legal Business Name): AVECINA MEDICAL, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2025
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

96031 VICTORIAS PL UNIT 111
YULEE FL
32097-8633
US

IV. Provider business mailing address

4815 SWEETGRASS PL UNIT 201
JACKSONVILLE FL
32224-0131
US

V. Phone/Fax

Practice location:
  • Phone: 904-326-5984
  • Fax: 904-310-3717
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AMANDA MORETTI KIGHT
Title or Position: BILLING MANAGER
Credential:
Phone: 904-367-3372