MEDICARE: ALINA HEALTH FOUNDATION INC.

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
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1346723137
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALINA HEALTH FOUNDATION INC.

Provider Business Mailing Address
First Line	:	1815 NE JACKSONVILLE RD STE B
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34470-4141
Country	:	US
Telephone Number	:	305-767-0887
Fax Number	:

Provider Business Practice Location Address
First Line	:	1815 NE JACKSONVILLE RD STE B
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34470-4141
Country	:	US
Telephone Number	:	305-767-0887
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. GRAVIL JOSEPH
Credential	:	PMHNP-BC
Telephone Number	:	305-767-0887

Provider Enumeration Date	:	09/08/2018
Last Update Date	:	12/06/2018

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Directions to “ALINA HEALTH FOUNDATION INC. ” Practice Location

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