PEDIATRIC SERVICES OF AMERICA LLC NPI 1164197919

NPI Information

NPI: 1164197919
Provider Name: PEDIATRIC SERVICES OF AMERICA, LLC

Doing Business As: AVEANNA HEALTHCARE

Classification: Clinic/Center - 261QR0400X
Entity Type: Organization

Specialization: Rehabilitation

Address:
760 NORTH DRIVE
SUITE E & F
MELBOURNE, FL
ZIP 32934
Phone: (321) 253-2000
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PEDIATRIC SERVICES OF AMERICA, LLC is a rehabilitation clinic center in Melbourne, FL. PEDIATRIC SERVICES OF AMERICA, LLC NPI is 1164197919. The provider is registered as an organization entity type.
The provider Is Doing Business As Aveanna Healthcare.

The provider's business location address is:

760 NORTH DRIVE
SUITE E & F
MELBOURNE, FL
ZIP 32934
Phone: (321) 253-2000

The provider's authorized official is Shannon Drake .
The authorized official title is Chief Legal Officer and has the following contact phone number (470) 464-8000.

The enumeration date for this NPI number is 8/13/2021 and was last updated on 2/26/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0400X	Clinic/Center	Rehabilitation			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	884161601	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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