Avalon Wellness Services LLC

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

ME34421 Issued in FL

Legal business name

AVALON WELLNESS SERVICES LLC

Practice address

6845 S Tropical TRL
Merritt Island, FL 32952-6512

Phone

(941) 685-6533

NPI assigned

May 20, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Stephen M Miley, MD

Title

Manager

Phone

(941) 685-6533

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1400544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411948800000",
    "number": "1083026447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6845 S TROPICAL TRL",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329526512",
            "telephone_number": "941-685-6533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6845 S TROPICAL TRL",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329526512",
            "telephone_number": "941-685-6533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON WELLNESS SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-20",
        "last_updated": "2014-09-29",
        "status": "A",
        "authorized_official_last_name": "MILEY",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "941-685-6533",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "ME34421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Atkinson-Kern, M.A. CCC-SLP
• Christopher Irby Atkinson, PT, DPT, CSCS
• Atlantic Coast Pediatrics, M.D. P.a.
• Karin A Atwell, LMT
• Karyna Auletta
• Az Health Solutions, LLC
• Ellyn Baergen, SLP
• Laura Elizabeth Baffa
• Joshua Bailey
• Opal Bailey

• Geriatric Medicine (Family Medicine) Physician in Merritt Island, FL
• Providers in Merritt Island, FL by specialty
• Geriatric Medicine (Family Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.