| Ace Medical Llc | |
|
6428 Beach Blvd Jacksonville FL 32216-2813 | |
| (904) 475-2039 | |
| (904) 330-0668 |
| Full Name | Ace Medical Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6428 Beach Blvd, Jacksonville, Florida |
| Authorized Official Name and Position | Joseph Ellyson (OFFICE MANAGER) |
| Authorized Official Contact | 9044752039 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ace Medical Llc 6428 Beach Blvd Jacksonville FL 32216-2813 Ph: (904) 475-2039 | Ace Medical Llc 6428 Beach Blvd Jacksonville FL 32216-2813 Ph: (904) 475-2039 |
| NPI Number | 1265772370 |
|---|---|
| Provider Enumeration Date | 02/26/2013 |
| Last Update Date | 03/06/2024 |
| Certification Date | 03/06/2024 |
| Medicare PECOS PAC ID | 3971745712 |
|---|---|
| Medicare Enrollment ID | O20130807000993 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265772370 | NPI | - | NPPES |
| 7635710004 | Other | NSC |
| Provider Name | Raul Soto-acosta |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619991106 PECOS PAC ID: 5799727228 Enrollment ID: I20050525000572 |
| Provider Name | Jaynell M Smith-cameron |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1235276189 PECOS PAC ID: 6901993237 Enrollment ID: I20071102000037 |
| Provider Name | George Camacho |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538154596 PECOS PAC ID: 6406925239 Enrollment ID: I20080520000686 |
| Provider Name | Diana M Cordero |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053357707 PECOS PAC ID: 7416015524 Enrollment ID: I20081018000005 |
| Provider Name | Nathan Roger Perry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073613295 PECOS PAC ID: 0446276240 Enrollment ID: I20100901000556 |
| Provider Name | Pradeep Khanna |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659705762 PECOS PAC ID: 7719112101 Enrollment ID: I20131018001342 |
| Provider Name | Robin Belcher-howard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104292200 PECOS PAC ID: 9537439088 Enrollment ID: I20170717002561 |
| Provider Name | Ebony R Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891293692 PECOS PAC ID: 5294096061 Enrollment ID: I20180719002594 |
| Provider Name | Johnnie Bradley-goodman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306322656 PECOS PAC ID: 0042561078 Enrollment ID: I20181001002367 |
| Provider Name | Leticia B Reno |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821306317 PECOS PAC ID: 9537318944 Enrollment ID: I20181211001786 |
| Provider Name | Manuel Gervasio Ruiz Dicks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184130916 PECOS PAC ID: 1850729625 Enrollment ID: I20200311000050 |
| Provider Name | Chelie Chenille Toler Buckley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902573256 PECOS PAC ID: 9537565981 Enrollment ID: I20210909002334 |
| Provider Name | Veronica H Bartley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851851554 PECOS PAC ID: 5597141721 Enrollment ID: I20220926002314 |
| Provider Name | Salia Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073294161 PECOS PAC ID: 5991159568 Enrollment ID: I20230930000279 |
| Provider Name | Darlene Burch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083499412 PECOS PAC ID: 4385099597 Enrollment ID: I20231009000492 |
| Provider Name | Stacey M Grant |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184278749 PECOS PAC ID: 1850839671 Enrollment ID: I20240812002683 |
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