| Kemshol Medical Center Pa | |
|
984 Orange Ave Daytona Beach FL 32114-4667 | |
| (386) 226-3008 | |
| (386) 226-3044 |
| Full Name | Kemshol Medical Center Pa |
|---|---|
| Speciality | Clinic/center |
| Location | 984 Orange Ave, Daytona Beach, Florida |
| Authorized Official Name and Position | Olubukunola Collins Thomas (PRESIDENT) |
| Authorized Official Contact | 4077564541 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kemshol Medical Center Pa 984 Orange Ave Daytona Beach FL 32114-4667 Ph: (386) 226-3008 | Kemshol Medical Center Pa 984 Orange Ave Daytona Beach FL 32114-4667 Ph: (386) 226-3008 |
| NPI Number | 1023213469 |
|---|---|
| Provider Enumeration Date | 06/16/2007 |
| Last Update Date | 10/27/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023213469 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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