Organization
ALIVIA CARE SOLUTIONS, INC.
Active
Other names
Alivia Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN PONDER-STANSEL (PRESIDENT & CEO)
(904) 407-5050
Entity
Organization
Contact information
Practice address
4266 SUNBEAM RD, JACKSONVILLE, FL 32257-2425
(904) 268-5200
Mailing address
4266 SUNBEAM RD, JACKSONVILLE, FL 32257-2425
(904) 407-5050
(904) 407-8123
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/10/2024
Last updated
04/10/2024
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