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General NPI Number Information
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NPI Number | 1740096502
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Entity Type | Organization
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Legal Business Name | AVECINA MEDICAL PA
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Dates
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Enumeration Date | 12/06/2024
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Last Update Date | 12/06/2024
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Provider Practice Location Address
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Address Line | 1640 TECHNOLOGY BLVD UNIT 110
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City | DAYTONA BEACH
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State | FL
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Zip | 32117-7315
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Country | US
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Telephone | 904-367-3372
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Fax |
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Provider Business Mailing Address
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Address Line | 4815 SWEETGRASS PL UNIT 201
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City | JACKSONVILLE
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State | FL
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Zip | 32224-0131
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Country | US
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Telephone | 904-367-3372
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Fax |
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | AMANDA MORETTI KIGHT
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Credential |
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Telephone | 904-367-3372
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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