| Dunlawton Family Medicine Plc | |
|
790 Dunlawton Ave Suite E Port Orange FL 32127-4222 | |
| (386) 760-1877 | |
| (386) 760-2791 |
| Full Name | Dunlawton Family Medicine Plc |
|---|---|
| Speciality | Clinic/Center |
| Location | 790 Dunlawton Ave, Port Orange, Florida |
| Authorized Official Name and Position | Mark David Kendrick (PRESIDENT) |
| Authorized Official Contact | 3867601877 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dunlawton Family Medicine Plc 790 Dunlawton Ave Suite E Port Orange FL 32127-4222 Ph: (386) 760-1877 | Dunlawton Family Medicine Plc 790 Dunlawton Ave Suite E Port Orange FL 32127-4222 Ph: (386) 760-1877 |
| NPI Number | 1629061767 |
|---|---|
| Provider Enumeration Date | 08/24/2005 |
| Last Update Date | 06/20/2012 |
| Medicare PECOS PAC ID | 0941250054 |
|---|---|
| Medicare Enrollment ID | O20050126000937 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629061767 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Mark Kendrick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306947452 PECOS PAC ID: 2668422775 Enrollment ID: I20100317000531 |
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