KENNETH DERBENWICK (NPI# 1366402562) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366402562 |
| Entity Type | Individual |
| Full Name | KENNETH DERBENWICK |
| Credential | MD |
| Practice Address |
350 N Clyde Morris Blvd Daytona Beach FL 32114 |
| Mailing Address |
Po Box 9671 Daytona Beach FL 32120 |
| Practice Telephone | 3862383200 |
| Mailing Telephone | 3866154015 |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 173000000X | Legal Medicine | ME0026485 | FL | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | VHN | ME0026485 | 01 |
| FL | UNITED BENEFITS | ME0026485 | 01 |
| Street Address |
350 N CLYDE MORRIS BLVD |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32114 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063405975 | Mary June Derbenwick | Psychiatry & Neurology | 350 N Clyde Morris Blvd, Daytona Beach, FL 32114-2733 | 2005-08-25 |
| 1205451705 | Tiffany Varela Khan | Nurse Practitioner | 350 N Clyde Morris Blvd, Daytona Beach, FL 32114-2733 | 2020-06-10 |
| 1245696301 | Andrea Likens | Dietitian, Registered | 350 N Clyde Morris Blvd, Suite 9, Daytona Beach, FL 32114-2733 | 2016-01-05 |
| 1245560291 | Cara J Karner | Dietetic Technician, Registered | 350 N Clyde Morris Blvd, Daytona Beach, FL 32114-2733 | 2010-01-13 |
| 1013189877 | Tyler Jay Staley | Physical Medicine & Rehabilitation | 350 N Clyde Morris Blvd, Daytona Beach, FL 32114-2733 | 2008-04-01 |
| 1083734784 | Mark A Miller | Pharmacist | 350 N Clyde Morris Blvd, Daytona Beach, FL 32114-2733 | 2007-03-29 |
| 1841322005 | Florida Health Care Plans Inc | Pharmacy | 350 N Clyde Morris Blvd, Daytona Beach, FL 32114-2733 | 2007-03-12 |
| 1730258088 | Richard Frank Miller | Nurse Practitioner | 350 N Clyde Morris Blvd, Daytona Beach, FL 32114-2733 | 2006-11-08 |
| 1154408904 | Joseph Michael Zobian | Ophthalmology | 350 N Clyde Morris Blvd, Daytona Beach, FL 32114-2733 | 2006-11-01 |
| 1518070119 | Niloufar Tabatabaei Wilson | Internal Medicine | 350 N Clyde Morris Blvd, Daytona Beach, FL 32114-2795 | 2006-08-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376161380 | Evolution Health & Performance LLC | Physician Assistant | 244 S. Palmetto Ave, Daytona Beach, FL 32114 | 2020-07-07 |
| 1407480189 | Kierra Imani Kinsey | Behavior Technician | 1128-a Beville Rd, Daytona Beach, FL 32114 | 2020-03-02 |
| 1043776057 | Outreach Community Care Network Inc | Pharmacy | 240 N. Frederick Avenue, Daytona Beach, FL 32114 | 2019-02-14 |
| 1033681861 | Katherine Proppe | Specialist/Technologist | 1 Aerospace Blvd, Daytona Beach, FL 32114 | 2018-12-18 |
| 1841765047 | Anna L Smith | Nurse Practitioner | 339 Bill France Blvd Ste C, Daytona Beach, FL 32114 | 2018-10-04 |
| 1154806933 | Steve Anthony Lee | Family Medicine | 731 N. Clyde Morris Blvd, Daytona Beach, FL 32114 | 2018-09-27 |
| 1285116491 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1348 W International Speedway Blvd Ste 2, Daytona Beach, FL 32114 | 2018-09-04 |
| 1770085656 | Merina Lee | Occupational Therapist | 1159 Australia Ave., Daytona Beach, FL 32114 | 2018-03-06 |
| 1346752755 | Hand & Upper Extremity Surgery of Daytona Beach, LLC | Non-Pharmacy Dispensing Site | 1241 Ridgewood Ave, Daytona Beach, FL 32114 | 2017-10-26 |
| 1104347053 | Harry Herman Blanke IIi | Family Medicine | 201 N Clyde Morris Blvd, Suite 200, Halifax Health Family Medicine Residency Program, Daytona Beach, FL 32114 | 2017-06-30 |
| Find all providers in zip 32114 | ||||
| Taxonomy Code | 173000000X |
| Grouping | Other Service Providers |
| Classification | Legal Medicine |
| The specialty areas of medicine concerned with matters of, and relations with, substantive law and legal institutions; such as the conduct of medical examinations at crime scenes, performance of autopsies, giving of expert medical testimony in judicial proceedings, medical treatment of inmates of penal institutions, the practice of trauma medicine in law enforcement settings, and other clinical practice and medical science applications in the fields of law, law enforcement, and corrections. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982925228 | John R. Parnell M.d., P.a. | Legal Medicine | 647 Orange Ave., Ste A, Daytona Beach, FL 32114 | 2010-06-22 |
| 1326016452 | George Telesh | Legal Medicine | 350 N Clyde Morris Blvd, Daytona Beach, FL 32114-2733 | 2006-03-14 |
| 1790757615 | William Borkosky | Legal Medicine | 350 N Clyde Morris Blvd, Daytona Beach, FL 32114-2733 | 2006-02-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679074561 | Joy Harris | Legal Medicine | 1950 Se Port St Lucie Blvd Ste 217, Port St Lucie, FL 34952-5579 | 2018-02-26 |
| 1386016137 | International Spine Center | Legal Medicine | 1310 Gulf Blvd Apt 2g, Clearwater, FL 33767-2859 | 2015-10-20 |
| 1639579923 | Duclos Dessalines | Legal Medicine | 4519 Lake Worth Rd, Greenacres, FL 33463-3449 | 2014-08-25 |
| 1679908867 | New Smyrna Pain & Injury Clinic | Legal Medicine | 421 N Causeway, New Smyrna Beach, FL 32169-5266 | 2013-09-06 |
| 1568710853 | Fmb Medical LLC | Legal Medicine | 7205 Estero Blvd Ste 733, Fort Myers Beach, FL 33931-4779 | 2012-08-17 |
| 1699047159 | Lazaro A Cabrera | Legal Medicine | 5575 Sw 77th Ct Apt 204b, Miami, FL 33155-4318 | 2012-01-30 |
| 1891074084 | Wellmed Medical Center | Legal Medicine | 9621 Bird Rd, Miami, FL 33165-4030 | 2011-08-05 |
| 1528377603 | William M. Escoffery | Legal Medicine | 300 Harbor Blvd Ste C, N/a, Destin, FL 32541-2370 | 2010-10-06 |
| 1538478086 | Nob Hill Medical Center, Inc. | Legal Medicine | 10098 W Mcnab Rd, Tamarac, FL 33321-1895 | 2010-10-01 |
| 1780992644 | Daniel Hunt II | Legal Medicine | 2160 Anchor Ave, Deland, FL 32720-2382 | 2010-09-14 |
| Find all providers with the same taxonomy | ||||
| City | DAYTONA BEACH |
| Zip Code | 32114 |
Please comment or provide details below to improve the information on KENNETH DERBENWICK.
| 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.