Active NPI
Evonna Almtanious
- Other Specialist/Technologist
- Jacksonville, FL
National Provider Identifier
1306483425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Specialist/Technologist
- License
- FB9767975
- Practice address
- 6410 Beach Blvd
Jacksonville, FL 32216-2813 - Phone
- (904) 493-6963
- Fax
- (904) 396-6963
- NPI assigned
- Dec 9, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Specialist/Technologist | 246Z00000X | FB9767975 | FL | Primary |
Addresses
Primary practice location
6410 Beach Blvd
Jacksonville, FL 32216-2813
Mailing address
PO Box 748817
Atlanta, GA 30374-8817
Phone (813) 286-0033
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| FB9767975 | FL | MD | Other Specialist/Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1575849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687478400000",
"number": "1306483425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 748817",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303748817",
"telephone_number": "813-286-0033",
"fax_number": "813-282-1806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6410 BEACH BLVD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322162813",
"telephone_number": "904-493-6963",
"fax_number": "904-396-6963"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALMTANIOUS",
"first_name": "EVONNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-09",
"last_updated": "2023-06-23",
"certification_date": "2023-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "246Z00000X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other",
"state": "FL",
"license": "FB9767975",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.