Avecina Medical, PA

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

AVECINA MEDICAL, PA

Practice address

4815 Sweetgrass Place
Suite 201
Jacksonville, FL 32224

Phone

(904) 367-3372

NPI assigned

Apr 2, 2024

Organization subpart

Yes

Parent organization

AVECINA MEDICAL, PAAs reported in NPPES

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

Authorized official

Name

Amanda Moretti Kight

Title

Billing Manager

Phone

(904) 367-3372

Specialties & licenses 1

Addresses

Part of

Avecina Medical PA

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Desteni Mariah Barnes, PA-C

  • Physician Assistant
  • St Johns, FL
  • NPI 1548666571
  NPD
• Valentine Iloduba, MSPAS PA-C

  • Physician Assistant
  • Jacksonville, FL
  • NPI 1871322693
  NPD
• Michael Drew Kight, P,A.

  • Medical Physician Assistant
  • Jacksonville, FL
  • NPI 1518119361
  NPD (past)

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

{
    "created_epoch": "1712016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722211200000",
    "number": "1740032028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 BLANDING BLVD STE 101",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320684935",
            "telephone_number": "904-203-2852",
            "fax_number": "904-406-0654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4815 SWEETGRASS PLACE",
            "address_2": "SUITE 201",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32224",
            "telephone_number": "904-367-3372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVECINA MEDICAL, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AVECINA MEDICAL, PA",
        "enumeration_date": "2024-04-02",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A",
        "authorized_official_last_name": "MORETTI KIGHT",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "904-367-3372"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Avecina Medical PA
• Avecina Medical PA
• Avecina Medical PA
• Avecina Medical, PA
• Avecina Medical, PA
• Nicole Avens, ARNP
• Jack Avent Jr., MA, CAP
• Avenues Cancer Care Institute, LLC
• Avenues Dental LLC
• Aveon Homecare

• All providers in Jacksonville, FL
• Urgent Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; 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.