| Northeast Florida Health Services, Inc. | |
|
2160 Howland Blvd Ste 110 Deltona FL 32738-3468 | |
| (386) 532-0515 | |
| (386) 532-0516 |
| Full Name | Northeast Florida Health Services, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 2160 Howland Blvd Ste 110, Deltona, Florida |
| Authorized Official Name and Position | Laurie Asbury (CEO) |
| Authorized Official Contact | 3867499449 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeast Florida Health Services, Inc. 1205 S Woodland Blvd Ste 3 Deland FL 32720-7464 Ph: (386) 202-6025 | Northeast Florida Health Services, Inc. 2160 Howland Blvd Ste 110 Deltona FL 32738-3468 Ph: (386) 532-0515 |
| NPI Number | 1790452688 |
|---|---|
| Provider Enumeration Date | 08/27/2021 |
| Last Update Date | 08/27/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790452688 | NPI | - | NPPES |
| 687955105 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Secondary |
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