Organization
PEDIATRIA HEALTHCARE, LLC
Active
Other names
Aveanna Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW BUCKHALTER (CFO)
(470) 464-8000
Entity
Organization
Contact information
Practice address
3492 MARTIN HURST RD, TALLAHASSEE, FL 32312-1702
(850) 701-3920
(850) 701-3924
Mailing address
400 INTERSTATE NORTH PKWY SE STE 1600, ATLANTA, GA 30339-5047
(470) 464-8000
Taxonomy
Speciality
Code
Description
License number
State
261QM3000X
Medically Fragile Infants and Children Day Care
Primary
60080986
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
240024300
—
FL
Enumeration date
04/23/2008
Last updated
01/27/2025
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