Daytona Beach Va Outpaitent Clinic
Clinic/Center in Daytona Beach, FL. Organization (NPI-2).
NPI number1225046626
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1225046626
- Entity type
- Organization (NPI-2)
- Legal business name
- Daytona Beach Va Outpaitent Clinic
- Organization subpart
- No
- Enumeration date
- Aug 3, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | ME 88745 | FL | Yes |
Practice location
551 National Health Care DrDaytona Beach, FL 32114-1495
Phone 386-323-7500
Mailing address
6810 Plumpjack CtPort Orange, FL 32128-4083
Phone 386-233-9774
Authorized official
Roger H. Bower
Chief Medical Officer
3863237542
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