Organization
PEDIATRIC SERVICES OF AMERICA, LLC
Active
Other names
Aveanna Heatlhcare
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW BUCKHALTER (CFO)
(470) 464-8000
Entity
Organization
Contact information
Practice address
8659 BAYPINE RD, STE 102, JACKSONVILLE, FL 32256-7577
(904) 730-2200
(904) 730-0630
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
HHA 20798096
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
650448500
—
FL
05
—
678778965
—
FL
05
—
681187696
—
FL
Enumeration date
07/05/2006
Last updated
01/27/2025
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