Organization
ADESSO PROFESSIONAL SERVICES LLC
Active
Other names
AMD PRIMARY CARE
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA D MAYNOLDI RN (ADMINISTRATOR)
(904) 579-4766
Entity
Organization
Contact information
Practice address
1202 KINGSLEY AVE, ORANGE PARK, FL 32073-4632
(877) 228-1221
(877) 842-4020
Mailing address
5000-18 US HWY 17 S, # 241, FLEMING ISLAND, FL 32003
(877) 228-1221
(877) 842-4020
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME130811
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1144591249
DAVID MAYNOLDI MD NPI #
FL
01
—
ME130811
DAVID MAYNOLDI'S FL MED LIC
FL
Enumeration date
03/14/2018
Last updated
11/13/2018
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