# ADESSO PROFESSIONAL SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** AMD PRIMARY CARE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730682808
- **Authorized official:** MARIA D MAYNOLDI RN (ADMINISTRATOR)
- **Authorized official phone:** (904) 579-4766

## Contact information

- **Practice address:** 1202 KINGSLEY AVE, ORANGE PARK, FL 32073-4632
- **Practice address phone:** (877) 228-1221
- **Practice address fax:** (877) 842-4020
- **Mailing address:** 5000-18 US HWY 17 S, \# 241, FLEMING ISLAND, FL 32003
- **Mailing address phone:** (877) 228-1221
- **Mailing address fax:** (877) 842-4020

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | ME130811 | FL | Yes |

## Other

- **Enumeration date:** 03/14/2018
- **Last updated:** 11/13/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1144591249 | DAVID MAYNOLDI MD NPI \# | FL |
| 01 | — | ME130811 | DAVID MAYNOLDI'S FL MED LIC | FL |