Provider Demographics
NPI:1043979453
Name:ALIVIA CARE SOLUTIONS, INC.
Entity Type:Organization
Organization Name:ALIVIA CARE SOLUTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:PONDER-STANSEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-407-6362
Mailing Address - Street 1:4266 SUNBEAM RD FL 32257
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32257-2425
Mailing Address - Country:US
Mailing Address - Phone:904-268-5200
Mailing Address - Fax:
Practice Address - Street 1:4266 SUNBEAM RD FL 32257
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257-2425
Practice Address - Country:US
Practice Address - Phone:904-268-5200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALIVIA CARE SOLUTIONS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-12-13
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty