| Amelia Express Care, Llc | |
|
1987 S 8th St Fernandina Beach FL 32034-3071 | |
| (904) 624-7003 | |
| (904) 212-1284 |
| Full Name | Amelia Express Care, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1987 S 8th St, Fernandina Beach, Florida |
| Authorized Official Name and Position | Jacob T Logsdon (MANAGER) |
| Authorized Official Contact | 9046247003 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amelia Express Care, Llc 1987 S 8th St Fernandina Beach FL 32034-3071 Ph: (904) 624-7003 | Amelia Express Care, Llc 1987 S 8th St Fernandina Beach FL 32034-3071 Ph: (904) 624-7003 |
| NPI Number | 1952701435 |
|---|---|
| Provider Enumeration Date | 09/03/2014 |
| Last Update Date | 06/15/2015 |
| Medicare PECOS PAC ID | 8628389244 |
|---|---|
| Medicare Enrollment ID | O20150623000855 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952701435 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | OS10149 (Florida) | Primary |
| Provider Name | Andrew D Magnet |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063411601 PECOS PAC ID: 7911000518 Enrollment ID: I20130924000693 |
| Provider Name | Jonathan Steven Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346391299 PECOS PAC ID: 6507954799 Enrollment ID: I20150623000993 |
| Provider Name | Victoria Smith Kilcawley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134211097 PECOS PAC ID: 7810161767 Enrollment ID: I20180223000404 |
| Provider Name | James Cutia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801182100 PECOS PAC ID: 6709055353 Enrollment ID: I20201118000223 |
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