AVECINA MEDICAL PA
NPI 1740096502
Clinic/Center - Urgent Care in Daytona Beach, FL

NPI Status: Active since December 06, 2024

Contact Information

1640 TECHNOLOGY BLVD UNIT 110
DAYTONA BEACH, FL
ZIP 32117
Phone: (904) 367-3372

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  • Organization
  • Clinic/Center
  • Urgent Care
  • CLIA Number: 10D2315899
  • CLIA Cert. Type: Other - URGENT CARE CENTER
  • CLIA Exp. Date: 12-19-2026

About AVECINA MEDICAL PA

This page provides the complete NPI Profile along with additional information for Avecina Medical Pa, a provider established in Daytona Beach, Florida operating as a Clinic/center, focusing in urgent care . The healthcare provider is registered in the NPI registry with number 1740096502 assigned on December 2024. The practitioner's primary taxonomy code is 261QU0200X. The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Amanda Moretti Kight (Billing Manager)

NPI
1740096502
Provider Name
AVECINA MEDICAL PA
Entity Type
Organization
Location Address
1640 TECHNOLOGY BLVD UNIT 110 DAYTONA BEACH, FL 32117
Location Phone
(904) 367-3372
Mailing Address
4815 SWEETGRASS PL UNIT 201 JACKSONVILLE, FL 32224
Mailing Phone
(904) 367-3372
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
12-06-2024
Last Update Date
12-06-2024
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Urgent Care

Taxonomy Code
261QU0200X
Type
Ambulatory Health Care Facilities

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

AMANDA MORETTI KIGHT

Authorized Official Title
BILLING MANAGER
Authorized Official Phone
(904) 367-3372

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
10D2315899
Facility Type
Other - URGENT CARE CENTER
Certificate Effective Date
December 20, 2024
Certificate Expiration Date
December 19, 2026
Laboratory Director
DMITIRY MODEL
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Avecina Medical Pa to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1740096502
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2780091250
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 8 + 0 + 0 + 9 + 1 + 2 + 5 + 0 + 24 = 58
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 58 = 22

The NPI number 1740096502 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1740096502, enumerated in the NPI registry as an "organization" on December 06, 2024

The provider is located at 1640 Technology Blvd Unit 110 Daytona Beach, Fl 32117 and the phone number is (904) 367-3372

This medical organization specializes in Clinic/Center with taxonomy code 261QU0200X with a focus in Urgent Care

The provider's CLIA number is 10D2315899 for a "other - urgent care center" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..

This NPI record was last updated on December 06, 2024. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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