| Pareto Population Health Management Practice Pllc | |
|
1697 Kings Rd Ste 1 Jacksonville FL 32209-6169 | |
| (904) 478-5483 | |
| (904) 478-5577 |
| Full Name | Pareto Population Health Management Practice Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 1697 Kings Rd Ste 1, Jacksonville, Florida |
| Authorized Official Name and Position | Kenyatta Lee (OWNER) |
| Authorized Official Contact | 9044785483 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pareto Population Health Management Practice Pllc 1697 Kings Rd Ste 1 Jacksonville FL 32209-6169 Ph: (904) 478-5483 | Pareto Population Health Management Practice Pllc 1697 Kings Rd Ste 1 Jacksonville FL 32209-6169 Ph: (904) 478-5483 |
| NPI Number | 1598396392 |
|---|---|
| Provider Enumeration Date | 01/30/2020 |
| Last Update Date | 08/10/2020 |
| Medicare PECOS PAC ID | 6103256623 |
|---|---|
| Medicare Enrollment ID | O20200424001795 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598396392 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Kenyatta Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588633630 PECOS PAC ID: 8123092871 Enrollment ID: I20040819001397 |
| Provider Name | Casey Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033867759 PECOS PAC ID: 6901285634 Enrollment ID: I20220627000234 |
| Provider Name | Natasha King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982327896 PECOS PAC ID: 8921477688 Enrollment ID: I20221220000954 |
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