| Aza Health | |
|
1305 N Orange Ave Green Cove Springs FL 32043-2553 | |
| (904) 284-5904 | |
| (904) 284-5905 |
| Full Name | Aza Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 1305 N Orange Ave, Green Cove Springs, Florida |
| Authorized Official Name and Position | Laura M Spencer (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 3863280108 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aza Health 1302 River St Palatka FL 32177-5042 Ph: (386) 326-7342 | Aza Health 1305 N Orange Ave Green Cove Springs FL 32043-2553 Ph: (904) 284-5904 |
| NPI Number | 1700135522 |
|---|---|
| Provider Enumeration Date | 09/07/2012 |
| Last Update Date | 02/13/2020 |
| Medicare PECOS PAC ID | 7214849520 |
|---|---|
| Medicare Enrollment ID | O20121221000053 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700135522 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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