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
1700 NW 64TH ST, STE 450, FORT LAUDERDALE, FL 33309-1800
(954) 567-9112
(954) 567-9328
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
251J00000X
Nursing Care Agency
Primary
HHA20620096
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
650733600
—
FL
05
—
650733696
—
FL
Enumeration date
06/30/2006
Last updated
01/27/2025
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