ORTHOPAEDIC CLINIC OF DAYTONA BEACH PA (NPI# 1073068458) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073068458 |
| Entity Type | Organization |
| Organization Name | ORTHOPAEDIC CLINIC OF DAYTONA BEACH PA |
| Practice Address |
1890 Lpga Boulevard Suite 240 Daytona Beach FL 32117-7131 |
| Mailing Address |
1075 Mason Avenue Daytona Beach FL 32117-4611 |
| Practice Telephone | 3862554596 |
| Practice Fax Number | 3862583561 |
| Mailing Telephone | 3862554596 |
| Mailing Fax Number | 3862583561 |
| Enumeration Date | 2016-08-16 |
| Last Update Date | 2018-06-01 |
| Authorized Official Name | ALBERT W GILLESPY (PRESIDENT) |
| Authorized Official Telephone | 3862554596 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | FL | Allopathic & Osteopathic Physicians | |
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | FL | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023678745 | Orthopaedic Clinic of Daytona Beach Pa | Durable Medical Equipment & Medical Supplies | 1175 Dunlawton Ave Ste 1, Port Orange, FL 32127-4741 | 2019-06-14 |
| 1164977534 | Orthopaedic Clinic of Daytona Beach Pa | Orthopaedic Surgery | 17 Old Kings Rd N Ste K, Palm Coast, FL 32137-8283 | 2016-08-16 |
| 1063965325 | Orthopaedic Clinic of Daytona Beach Pa | Orthopaedic Surgery | 1165 Dunlawton Ave, Suite 102, Port Orange, FL 32127-2924 | 2016-08-03 |
| 1558340240 | Orthopaedic Clinic of Daytona Beach Pa | Orthopaedic Surgery | 1075 Mason Ave, Daytona Beach, FL 32117-4611 | 2006-01-11 |
| Street Address |
1890 LPGA BOULEVARD SUITE 240 |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32117-7131 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992350409 | Erin Selfridge | Pharmacist | 1500 Beville Rd #300, Daytona Beach, FL 32117 | 2019-08-02 |
| 1881185494 | Wellspring Health, LLC | Chiropractor | 701 Ridgewood Ave, Holly Hills, FL 32117 | 2018-05-21 |
| 1780172791 | L & L Db, LLC | Clinic/Center | 1540 Cornerstone Blvd, Suite 100, Daytona Beach, FL 32117 | 2018-04-25 |
| 1154837789 | Brittany Nikolow | Nurse Practitioner | 1717 N. Clyde Morris, Daytona Beach, FL 32117 | 2017-12-19 |
| 1205356946 | Alejandro Andre Pabon Rodriguez | Nurse Anesthetist, Certified Registered | Florida Hospital Memorial Medical Center, 301 Memorial Medical Parkway, Daytona Beach, FL 32117 | 2017-06-23 |
| 1316492135 | Ann Van Herck | Physical Therapist | 1901 Mason Ave Ste 105, Daytona Beach, FL 32117 | 2016-08-22 |
| 1952784779 | Kathryn Brenna Copley | Nurse Practitioner | 1890 Lpga Blvd., Daytona Beach, FL 32117 | 2015-06-30 |
| 1053719559 | Alicia Graham | Case Manager/Care Coordinator | 1570 Megan Bay Circle, Holly Hill, FL 32117 | 2014-12-15 |
| 1578974440 | Halifax Senior Care Inc | Clinic/Center | 1515 Ridgewood Ave, Suite B, Holly Hill, FL 32117 | 2014-05-14 |
| 1013345883 | Kist Alf, Inc | Assisted Living Facility | 1516 Carmen Avenue, Daytona Beach, FL 32117 | 2013-10-14 |
| Find all providers in zip 32117 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770116642 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 303 N Clyde Morris Blvd Ste 1001, Daytona Beach, FL 32114-2709 | 2020-02-19 |
| 1710531454 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 2630 Lpga Blvd, Daytona Beach, FL 32124-1008 | 2019-07-31 |
| 1285116491 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1348 W International Speedway Blvd Ste 2, Daytona Beach, FL 32114 | 2018-09-04 |
| 1376921122 | 24/7 Medical LLC | Durable Medical Equipment & Medical Supplies | 740 Fentress Blvd Ste 100, Daytona Beach, FL 32114-1249 | 2015-05-13 |
| 1518203470 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 2595 N Atlantic Ave, Daytona Beach, FL 32118-3203 | 2012-12-21 |
| 1407166283 | Publix Super Markets Inc | Durable Medical Equipment & Medical Supplies | 1500 Beville Rd Ste 300, Daytona Beach, FL 32114-5644 | 2010-10-14 |
| 1174839617 | Home Delivery Incontinent Supplies Co Inc | Durable Medical Equipment & Medical Supplies | 1310 S Ridgewood Ave, Daytona Beach, FL 32114-7251 | 2010-08-22 |
| 1366513293 | Hanger Prosthetics & Orthotics Inc | Durable Medical Equipment & Medical Supplies | 1400 Mason Ave Ste 130, Daytona Beach, FL 32117-5501 | 2006-11-13 |
| 1285704593 | Daytona Peoples Medical Supply | Durable Medical Equipment & Medical Supplies | 955 Orange Ave, Suite 110, Daytona Beach, FL 32114-4675 | 2006-11-08 |
| 1952497612 | Ability Health Services, Inc | Durable Medical Equipment & Medical Supplies | 614 N. Penisula Dr, Daytona Beach, FL 32118 | 2006-10-04 |
| Find all providers in DAYTONA BEACH | ||||
| City | DAYTONA BEACH |
| Zip Code | 32117 |
Please comment or provide details below to improve the information on ORTHOPAEDIC CLINIC OF DAYTONA BEACH PA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.