MEDICARE: AVALON CLIENT SERVICES, 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
1	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1902348626
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AVALON CLIENT SERVICES, LLC

Provider Business Mailing Address
First Line	:	3405 W DR MARTIN LUTHER KING JR BLVD
Second Line	:	SUITE 200
City	:	TAMPA
State	:	FL
Zip	:	33607-6212
Country	:	US
Telephone Number	:	813-751-3800
Fax Number	:

Provider Business Practice Location Address
First Line	:	3405 W DR MARTIN LUTHER KING JR BLVD
Second Line	:	SUITE 200
City	:	TAMPA
State	:	FL
Zip	:	33607-6212
Country	:	US
Telephone Number	:	813-751-3800
Fax Number	:

Authorized Official
Title or Position	:	GENERAL COUNSEL
Name	:	MR. STEVEN D. MORGAN
Credential	:
Telephone Number	:	813-751-3855

Provider Enumeration Date	:	11/11/2016
Last Update Date	:	01/24/2017

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