| Humana Physician Group | |
|
731 N Clyde Morris Blvd Daytona Beach FL 32114-1603 | |
| (386) 257-1626 | |
| Not Available |
| Full Name | Humana Physician Group |
|---|---|
| Speciality | Family Medicine |
| Location | 731 N Clyde Morris Blvd, Daytona Beach, Florida |
| Authorized Official Name and Position | Jessica Marie Bonetti (ASSOCIATE DIRECTOR) |
| Authorized Official Contact | 3055002000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Humana Physician Group 6101 Blue Lagoon Dr Ste 200 Miami FL 33126-3168 Ph: (305) 500-2114 | Humana Physician Group 731 N Clyde Morris Blvd Daytona Beach FL 32114-1603 Ph: (386) 257-1626 |
| NPI Number | 1427433135 |
|---|---|
| Provider Enumeration Date | 07/23/2015 |
| Last Update Date | 08/19/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427433135 | NPI | - | NPPES |
| CX415B | Other | FL | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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