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Organization
AVNER ASSET LLC
Active
Organization
AVNER ASSET LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN DOREUS (GENERAL MANAGER)
(760) 805-6602
Entity
Organization
Contact information
Practice address
425 MYRTLEWOOD CIR, JACKSONVILLE, NC 28546-7411
(760) 805-6602
Mailing address
425 MYRTLEWOOD CIR, JACKSONVILLE, NC 28546-7411
(760) 805-6602
Taxonomy
Speciality
Code
Description
License number
State
261QM1102X
Military Outpatient Operational (Transportable) Component Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D620-460-78-067-0
FL DMV
FL
01
—
L17000152385
FL DEPT OF STATE
FL
Enumeration date
10/05/2021
Last updated
10/12/2021
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