| Convenient Care And Assessment Llc | |
|
2407 S Peninsula Dr Daytona Beach FL 32118-5412 | |
| (386) 212-1222 | |
| Not Available |
| Full Name | Convenient Care And Assessment Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 2407 S Peninsula Dr, Daytona Beach, Florida |
| Authorized Official Name and Position | Desiree Ihilani Deginder (PROVIDER/CEO) |
| Authorized Official Contact | 3862121222 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Convenient Care And Assessment Llc 2407 S Peninsula Dr Daytona Beach FL 32118-5412 Ph: (386) 212-1222 | Convenient Care And Assessment Llc 2407 S Peninsula Dr Daytona Beach FL 32118-5412 Ph: (386) 212-1222 |
| NPI Number | 1609430388 |
|---|---|
| Provider Enumeration Date | 04/28/2019 |
| Last Update Date | 04/28/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609430388 | NPI | - | NPPES |
| JN947 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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