| Excellence Health, Llc | |
|
1630 Mason Ave Ste C Daytona Beach FL 32117-4547 | |
| (386) 238-9064 | |
| (386) 238-9063 |
| Full Name | Excellence Health, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1630 Mason Ave Ste C, Daytona Beach, Florida |
| Authorized Official Name and Position | Rachael Mitchell (BILLER) |
| Authorized Official Contact | 3862389064 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Excellence Health, Llc 1630 Mason Ave Daytona Beach FL 32117-4547 Ph: () - | Excellence Health, Llc 1630 Mason Ave Ste C Daytona Beach FL 32117-4547 Ph: (386) 238-9064 |
| NPI Number | 1447741749 |
|---|---|
| Provider Enumeration Date | 05/22/2018 |
| Last Update Date | 09/19/2018 |
| Medicare PECOS PAC ID | 0840534160 |
|---|---|
| Medicare Enrollment ID | O20181127002760 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447741749 | NPI | - | NPPES |
| 273953400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME94169 (Florida) | Primary |
| Provider Name | Franklyn F Dontfraid |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1447243423 PECOS PAC ID: 7315974847 Enrollment ID: I20050727000136 |
| Provider Name | Husam E Eddin |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1629082607 PECOS PAC ID: 7113945874 Enrollment ID: I20051110000748 |
| Provider Name | Chuni G Kwong |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1215001946 PECOS PAC ID: 6901992270 Enrollment ID: I20071017000860 |
| Provider Name | Kristin L Wulff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285771444 PECOS PAC ID: 5799876637 Enrollment ID: I20091007000274 |
| Provider Name | Radharani S Gollamudi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245287713 PECOS PAC ID: 0547271652 Enrollment ID: I20110701000152 |
| Provider Name | Michelle A Powell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376832816 PECOS PAC ID: 1658540141 Enrollment ID: I20110818000449 |
| Provider Name | Jennifer L Von Stroh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174864482 PECOS PAC ID: 6800039512 Enrollment ID: I20160106000518 |
| Provider Name | Sarah E Barbel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912355140 PECOS PAC ID: 7618262106 Enrollment ID: I20160823001630 |
| Provider Name | Emma Ems |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548614647 PECOS PAC ID: 2365720711 Enrollment ID: I20161105000226 |
| Provider Name | Sherida Ann Hahn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508218454 PECOS PAC ID: 2860775673 Enrollment ID: I20170201001529 |
| Provider Name | Holly A Mulvey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639534159 PECOS PAC ID: 8123304565 Enrollment ID: I20170419000781 |
| Provider Name | Sara R Schiffman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225571714 PECOS PAC ID: 7416222575 Enrollment ID: I20170929001093 |
| Provider Name | Antonio M Portilla Cintron |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1700204005 PECOS PAC ID: 2466673124 Enrollment ID: I20171010003525 |
| Provider Name | Casey Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760992317 PECOS PAC ID: 2264799600 Enrollment ID: I20171120002868 |
| Provider Name | Diane G Meadows |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275072142 PECOS PAC ID: 2365705142 Enrollment ID: I20180409000460 |
| Provider Name | Mallory M Gustafson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144728486 PECOS PAC ID: 0446514921 Enrollment ID: I20180509001387 |
| Provider Name | Jeanine Tripp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700449238 PECOS PAC ID: 0345582573 Enrollment ID: I20190508001672 |
| Provider Name | Kathryn A Erickson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588200885 PECOS PAC ID: 5698101012 Enrollment ID: I20200204000493 |
| Provider Name | Amy R Swiatkowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790005452 PECOS PAC ID: 8628260726 Enrollment ID: I20200205002805 |
| Provider Name | Cynthia K Flynn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962595033 PECOS PAC ID: 9931002813 Enrollment ID: I20200323003057 |
| Provider Name | Aliah Aquila Price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952886848 PECOS PAC ID: 0648609842 Enrollment ID: I20200409002858 |
| Provider Name | Jenilee Marcinkiewicz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164033288 PECOS PAC ID: 7517387616 Enrollment ID: I20201012000375 |
| Provider Name | Jeanne M Kerr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790328094 PECOS PAC ID: 3173956281 Enrollment ID: I20210913001351 |
| Provider Name | Jose Chavez Gonzalez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649619388 PECOS PAC ID: 4981921442 Enrollment ID: I20211021000963 |
| Provider Name | Delayna Lauren Donohue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285390328 PECOS PAC ID: 7315337300 Enrollment ID: I20211207000121 |
| Provider Name | Cindy Lynne Perdue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366103236 PECOS PAC ID: 0244466118 Enrollment ID: I20220126002981 |
| Provider Name | Cameika Odelvez Shepherd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245995992 PECOS PAC ID: 5890188353 Enrollment ID: I20220203002648 |
| Provider Name | Stephania Angel Schmitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689331738 PECOS PAC ID: 7810380169 Enrollment ID: I20220208002998 |
| Provider Name | Noah Benjamin Bigman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306419163 PECOS PAC ID: 8022403096 Enrollment ID: I20220310000942 |
| Provider Name | Heather Leanne Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225775729 PECOS PAC ID: 3274912381 Enrollment ID: I20220621001406 |
| Provider Name | Katia Robelo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518680008 PECOS PAC ID: 8729464664 Enrollment ID: I20220930000554 |
| Provider Name | Kenessa Susan Ugarte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811601511 PECOS PAC ID: 4486025772 Enrollment ID: I20230124003111 |
| Provider Name | Uhuru Bullock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578871869 PECOS PAC ID: 2961894423 Enrollment ID: I20230323002265 |
| Provider Name | Kendra White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528757838 PECOS PAC ID: 4880051564 Enrollment ID: I20230612002360 |
| Provider Name | Tania G Morales |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629774229 PECOS PAC ID: 2163874637 Enrollment ID: I20240119002977 |
| Provider Name | Heather Marie Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508467523 PECOS PAC ID: 7214380104 Enrollment ID: I20240126002534 |
| Provider Name | Christyn Fuller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841901071 PECOS PAC ID: 9234572074 Enrollment ID: I20240208000923 |
| Provider Name | Sarah Dallos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164280251 PECOS PAC ID: 3779924824 Enrollment ID: I20240507003901 |
| Provider Name | Susan S Bigman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265218911 PECOS PAC ID: 9537500756 Enrollment ID: I20240517002829 |
| Provider Name | Kelli Knight Overturf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902664568 PECOS PAC ID: 1951843077 Enrollment ID: I20240605000013 |
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