1396801783 NPI number — HEALTH ADVANTAGES, P.A.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396801783 NPI number — HEALTH ADVANTAGES, P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALTH ADVANTAGES, P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396801783
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2575 COUNTY ROAD 220
Provider Second Line Business Mailing Address:
SUITE 108
Provider Business Mailing Address City Name:
MIDDLEBURG
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32068-6550
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
904-276-5525
Provider Business Mailing Address Fax Number:
904-276-5527

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2575 COUNTY ROAD 220
Provider Second Line Business Practice Location Address:
SUITE 108
Provider Business Practice Location Address City Name:
MIDDLEBURG
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32068-6550
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
904-276-5525
Provider Business Practice Location Address Fax Number:
904-276-5527
Provider Enumeration Date:
12/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SPRING
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
ALAN
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
904-276-5525

Provider Taxonomy Codes

  • Taxonomy code: 261QM2500X , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 666076 . This is a "GREAT-WEST HEALTHCARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 666076 . This is a "ACN CORPORATION" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 666076 . This is a "OXFORD HEALTHCARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 666076 . This is a "DEFINITY HEALTHCARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 3402249 . This is a "CIGNA HEALTHCARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 9412002 . This is a "PRIVATE HEALTHCARE SYSTEM" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 88400 . This is a "BLUECROSS BLUESHIELD" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 706214 . This is a "GOLDEN RULE HEALTHCARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 666076 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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