Organization
PEDIATRIC SERVICES OF AMERICA, 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
126 INTEGRA BREEZE LN STE 3B, DAYTONA BEACH, FL 32117-5554
(386) 304-0702
Mailing address
400 INTERSTATE NORTH PKWY SE STE 1600, ATLANTA, GA 30339-5047
(470) 464-8000
(770) 248-8192
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251J00000X
Nursing Care Agency
Primary
HHA220370961
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
650786700
—
FL
05
—
680444679
—
FL
05
—
681259796
—
FL
Enumeration date
07/07/2006
Last updated
01/27/2025
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