BRENT N. FULTON (NPI# 1194708495) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194708495 |
| Entity Type | Individual |
| Full Name | BRENT N. FULTON |
| Credential | M.D. |
| Practice Address |
3127 W International Speedway Blvd. Daytona Beach FL 32124 |
| Practice Telephone | 3862589502 |
| Practice Fax Number | 3862399781 |
| Mailing Telephone | 3862589502 |
| Mailing Fax Number | 3862399781 |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2019-03-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | ME94759 | FL | Allopathic & Osteopathic Physicians |
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
ME94759 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
3127 W INTERNATIONAL SPEEDWAY BLVD. |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32124 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407302599 | Christine Lapila | Behavioral Analyst | 201 Thornberg Branch Lane, Daytona Beach, FL 32124 | 2016-08-29 |
| 1891212130 | Brian Moore | Early Intervention Provider Agency | 201 Thornberry Branch Ln, Daytona Beach, FL 32124 | 2017-08-28 |
| 1588834725 | Glendoria Stephens | Counselor | 3875 Tiger Bay Rd, Rm 914 Bldg I, Daytona Beach, FL 32124 | 2008-03-04 |
| 1003146887 | Sequel Tsi of Florida, LLC Daytona Transitional | Residential Treatment Facility, Emotionally Disturbed Children | 1386 Indian Lake Rd, Daytona Beach, FL 32124-1001 | 2009-12-30 |
| 1376874370 | Sequel Tsi of Florida, LLC Daytona Residential Treatment Center | Psychiatric Residential Treatment Facility | 1386 Indian Lake Rd, Daytona Beach, FL 32124-1001 | 2010-01-15 |
| 1710531454 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 2630 Lpga Blvd, Daytona Beach, FL 32124-1008 | 2019-07-31 |
| 1336746544 | Kyle Adams | Pharmacist | 2630 Lpga Blvd, Daytona Beach, FL 32124-1008 | 2020-10-01 |
| 1750369666 | Sma Healthcare Inc | Community/Behavioral Health | 1150 Red John Road, Daytona Beach, FL 32124-1016 | 2006-01-03 |
| 1396742490 | Theodore Frank Matejka | Nurse Practitioner | 1150 Red John Dr, Daytona Beach, FL 32124-1016 | 2005-07-05 |
| 1104464882 | Dane Huge | Nurse Practitioner | 1150 Red John Dr, Daytona Beach, FL 32124-1016 | 2019-12-13 |
| Find all providers in zip 32124 | ||||
| Taxonomy Code | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245283530 | Halifax Healthcare Systems Inc | Family Medicine | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 | 2006-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720607484 | Black Stallion Walk-in and Exercise Medicine Clinics LLC | Family Medicine | 9955 Se Federal Hwy, Hobe Sound, FL 33455-4829 | 2020-04-13 |
| 1003371519 | Affordable Medical Clinic of Wellii | Family Medicine | 12773 Forest Hill Blvd Ste 1203, Wellington, FL 33414-4760 | 2019-02-08 |
| 1609391929 | Baptist Physician Group LLC | Family Medicine | 8880 Navarre Pkwy Ste 206, Navarre, FL 32566-3614 | 2017-08-08 |
| 1568997880 | Sports Medicine and Rehab Fitness | Family Medicine | 4405 Crooked Mile Rd, Merritt Island, FL 32952-6310 | 2017-04-24 |
| 1770037822 | Daniel Gonzalez | Family Medicine | 11050 Griffin Rd, Davie, FL 33328-3226 | 2016-08-06 |
| 1497174478 | John Sami Maarouf | Family Medicine | 301 Harbour Place Dr Unit 2007, Tampa, FL 33602-6808 | 2014-04-07 |
| 1487091393 | Michelle Henne | Family Medicine | 5535 Cypress Gardens Blvd Ste 270, Winter Haven, FL 33884-2241 | 2013-05-31 |
| 1053678151 | Jonathan Paul Bonnet | Family Medicine | 4830 Nw 43rd St, M194, Gainesville, FL 32606-4401 | 2012-04-13 |
| 1891092862 | Ozaki, Inc. | Family Medicine | 1600 S Ocean Dr Apt 17d, Hollywood, FL 33019-2427 | 2011-02-28 |
| 1174839161 | John Broussard | Family Medicine | 111 2nd Ave Ne Ste 1401, St Petersburg, FL 33701-3480 | 2010-08-27 |
| Find all providers with the same taxonomy | ||||
| City | DAYTONA BEACH |
| Zip Code | 32124 |
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| 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.