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NPI Code Detail

MEDICARE: DUVAL APS LLC

MEDICARE: DUVAL APS LLC
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
1251S00000XCommunity/Behavioral Health Agency
2207QA0401XAddiction Medicine (Family Medicine) Physician

General Provider Information

NPI Number : 1184088650
Entity Type Code : Organization
Provider Name (Legal Business Name) : DUVAL APS LLC
Provider Business Mailing Address
First Line : 2500 MAITLAND CENTER PKWY
Second Line : SUITE 250
City : MAITLAND
State : FL
Zip : 32751-7224
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 590 ELLIS RD S BLDG 4
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32254-3555
Country : US
Telephone Number : 904-800-6563
Fax Number :
Authorized Official
Title or Position : CEO
Name : JOHN STEIBRUN
Credential :
Telephone Number : 407-351-7080
Provider Enumeration Date : 04/11/2016
Last Update Date : 10/14/2016

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