| Ocean Road Llc | |
|
3520 W International Speedway Blvd Daytona Beach FL 32124-1026 | |
| (386) 527-2160 | |
| Not Available |
| Full Name | Ocean Road Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3520 W International Speedway Blvd, Daytona Beach, Florida |
| Authorized Official Name and Position | Elizabeth Ann Ferguson (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3865272160 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ocean Road Llc Po Box 2633 Bunnell FL 32110-2633 Ph: (386) 527-2160 | Ocean Road Llc 3520 W International Speedway Blvd Daytona Beach FL 32124-1026 Ph: (386) 527-2160 |
| NPI Number | 1467805465 |
|---|---|
| Provider Enumeration Date | 07/14/2016 |
| Last Update Date | 07/14/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467805465 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | SW10893 (Florida) | Primary |
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