| Altitude Health Corp I Llc | |
|
9905 Old Saint Augustine Rd Ste 400 Jacksonville FL 32257-8856 | |
| (904) 374-8843 | |
| Not Available |
| Full Name | Altitude Health Corp I Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 9905 Old Saint Augustine Rd Ste 400, Jacksonville, Florida |
| Authorized Official Name and Position | Adam Berk (CEO/PARTNER) |
| Authorized Official Contact | 9176907556 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Altitude Health Corp I Llc 9905 Old Saint Augustine Rd Ste 400 Jacksonville FL 32257-8856 Ph: () - | Altitude Health Corp I Llc 9905 Old Saint Augustine Rd Ste 400 Jacksonville FL 32257-8856 Ph: (904) 374-8843 |
| NPI Number | 1831970029 |
|---|---|
| Provider Enumeration Date | 10/12/2023 |
| Last Update Date | 10/12/2023 |
| Certification Date | 10/12/2023 |
| Medicare PECOS PAC ID | 4587004395 |
|---|---|
| Medicare Enrollment ID | O20240426002164 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831970029 | NPI | - | NPPES |
| Provider Name | Nicholas M Kalynych |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1003884347 PECOS PAC ID: 0749178580 Enrollment ID: I20040304001031 |
| Provider Name | Patricia Junquera |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750583969 PECOS PAC ID: 2961568225 Enrollment ID: I20090311000666 |
| Provider Name | Amanda Kathleen Alexander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891461471 PECOS PAC ID: 6204221914 Enrollment ID: I20220316000955 |
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