Constancia Clinic House Call LLC
Nurse Practitioner, Family in Daytona Beach, FL. Organization (NPI-2).
NPI number1194635789
StatusActive
Last updated in NPPESSep 8, 2026
Details
- NPI
- 1194635789
- Entity type
- Organization (NPI-2)
- Legal business name
- Constancia Clinic House Call LLC
- Organization subpart
- No
- Enumeration date
- Sep 8, 2026
- Certification date
- Sep 5, 2026
- Last updated
- Sep 8, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | – | – | Yes |
Practice location
1616 Concierge Blvd Ste 100Daytona Beach, FL 32117-7159
Phone 786-769-0031 · Fax 386-246-2149
Mailing address
1616 Concierge Blvd Ste 100Daytona Beach, FL 32117-7159
Phone 786-769-0031 · Fax 386-246-2149
Authorized official
Humberto Lorenzo Paez
Nurse Practitioner
7867690031
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