Skilled Nursing Infectious Disease Llc | |
6817 Southpoint Parkway #801 Jacksonville FL 32216 | |
(904) 537-3765 | |
(904) 641-1017 |
Full Name | Skilled Nursing Infectious Disease Llc |
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Speciality | Internal Medicine |
Location | 6817 Southpoint Parkway #801, Jacksonville, Florida |
Authorized Official Name and Position | Ammala Cantrell (OWNER/MANAGER) |
Authorized Official Contact | 9046735553 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Skilled Nursing Infectious Disease Llc Po Box 23338 Jacksonville FL 32241 Ph: (904) 673-5553 | Skilled Nursing Infectious Disease Llc 6817 Southpoint Parkway #801 Jacksonville FL 32216 Ph: (904) 537-3765 |
NPI Number | 1679350722 |
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Provider Enumeration Date | 09/12/2023 |
Last Update Date | 09/12/2023 |
Medicare PECOS PAC ID | 5294185427 |
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Medicare Enrollment ID | O20231229001020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1679350722 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
Provider Name | Pablo M Pella |
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Provider Type | Practitioner - Infectious Disease |
Provider Identifiers | NPI Number: 1245347004 PECOS PAC ID: 2668453671 Enrollment ID: I20101019000130 |
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