NPI 1275083727

Veenakumar

Organisation PACE Provider Organization Jacksonville, FL

Practice location

Address: 12152 Basalt Dr S, Jacksonville, FL 32246-0680
Phone: (904) 619-4204

Authorised official

Name: Veena Kumar
Title: Manager
Phone: (904) 619-4204

Registered specialties

PACE Provider Organization Primary

Agencies Taxonomy 251T00000X Licence W268696 (FL)

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Registry record

NPI: 1275083727
Entity type: Organization
NPI issued: 8 Oct 2016
Record last updated: 8 Oct 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.