JSK JSN LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

JSK JSN LLC

Doing business as

Avalon Medical Walk In Clinic

Practice address

14807 E Colonial Dr
Suite 112
Orlando, FL 32826-5122

Phone

(407) 250-6742

NPI assigned

Jun 26, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Kaushikkumar K. Patel, MD

Title

Doctor

Phone

(321) 289-1951

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Avalon Medical Walk In Clinic Doing business as

Locations

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

{
    "created_epoch": "1435276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466553600000",
    "number": "1437531308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14807 E COLONIAL DR",
            "address_2": "SUITE 112",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328265122",
            "telephone_number": "321-289-1951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14807 E COLONIAL DR",
            "address_2": "SUITE 112",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328265122",
            "telephone_number": "407-250-6742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JSK JSN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-26",
        "last_updated": "2016-06-22",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "KAUSHIKKUMAR",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "321-289-1951",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17451100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avalon Medical Walk In Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Specialist in Orlando, FL
• Providers in Orlando, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2016; 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.