ACE MEDICAL LLC (NPI# 1053838946) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053838946 |
| Entity Type | Organization |
| Organization Name | ACE MEDICAL LLC |
| Practice Address |
112 W Highland Blvd Inverness FL 34452-4819 |
| Mailing Address |
9471 Baymeadows Rd Ste 405 Jacksonville FL 32256-7937 |
| Practice Telephone | 9044752039 |
| Practice Fax Number | 9043300668 |
| Mailing Telephone | 9042383752 |
| Mailing Fax Number | 9045139250 |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2018-11-09 |
| Authorized Official Name | DIANA M CORDERO (OWNER/PRESIDENT) |
| Authorized Official Telephone | 9042383752 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NSC | 7635710001 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801313788 | Ace Medical LLC | Clinic/Center | 3450 Dunn Ave Ste 302, Jacksonville, FL 32218-6427 | 2017-08-23 |
| 1609393594 | Ace Medical LLC | Clinic/Center | 665 State Road 207 Ste 101b, St Augustine, FL 32084-5939 | 2017-08-23 |
| 1154742328 | Ace Medical LLC | Prosthetic/Orthotic Supplier | 2702 1st Ave, Huntington, WV 25702-1340 | 2013-12-13 |
| 1427237262 | Ace Medical LLC | Durable Medical Equipment & Medical Supplies | 1110 W Evans St, Florence, SC 29501-3320 | 2007-10-29 |
| 1265772370 | Ace Medical LLC | Psychologist | 3720 Beach Blvd, Jacksonville, FL 32207-3814 | 2013-02-26 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ACE MEDICAL LLC | 2702 1st Ave, Huntington, WV 25702-1340 |
| Street Address |
112 W HIGHLAND BLVD |
| City | INVERNESS |
| State | FL |
| Zip Code | 34452-4819 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750366290 | Thomas R Syverson | Family Medicine | 112 W Highland Blvd, Inverness, FL 34452-4819 | 2005-12-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528680204 | Medical Risk Solutions LLC | Family Medicine | 216-c South Apopka Ave., Inverness, FL 34452 | 2020-05-15 |
| 1801354204 | Mari Parker | Nurse Practitioner | 520 W Highland Blvd, Inverness, FL 34452 | 2019-03-05 |
| 1346737061 | Sharma Institute of Pain Medicine | Physical Medicine & Rehabilitation | 211 South Seminole Ave, Inverness, FL 34452 | 2018-04-18 |
| 1548779846 | Alexandra Weinmann | Behavior Technician | 6765 E Kingsbury Lane, Inverness, FL 34452 | 2017-09-29 |
| 1821536913 | Mechelle Louise Lewis | Nurse Practitioner | 212 S. Pine Avenue, Inverness, FL 34452 | 2017-02-08 |
| 1639615131 | Elizabeth Lynch | Behavioral Analyst | 609 Goodyear Ave, Inverness, FL 34452 | 2017-01-09 |
| 1942511100 | Families Come First, LLC | In Home Supportive Care | 220 S Pine Ave, Invenress, FL 34452 | 2010-06-23 |
| 1639342470 | Assisted Living Concepts Inc | Assisted Living Facility | 700 Medical Court East, Inverness, FL 34452 | 2008-04-11 |
| 1063684686 | Winn-dixie Stores, Inc. | Durable Medical Equipment & Medical Supplies | 333 Highland Ave Space 600, Inverness, FL 34452 | 2008-03-25 |
| 1831372606 | Gira S. Shah, Md, Pa | Internal Medicine | 203 S. Seminole Ave, Inverness, FL 34452 | 2007-12-14 |
| Find all providers in zip 34452 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.