| Northwest Family Health Center Ii, Llc | |
|
1630 Mason Ave Ste B Daytona Beach FL 32117-4503 | |
| (386) 888-4006 | |
| (386) 675-6610 |
| Full Name | Northwest Family Health Center Ii, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1630 Mason Ave Ste B, Daytona Beach, Florida |
| Authorized Official Name and Position | Garry Beaubrun Antoine (PRESIDENT & CEO) |
| Authorized Official Contact | 8458211291 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwest Family Health Center Ii, Llc Po Box 951306 Lake Mary FL 32795-1306 Ph: (386) 888-4006 | Northwest Family Health Center Ii, Llc 1630 Mason Ave Ste B Daytona Beach FL 32117-4503 Ph: (386) 888-4006 |
| NPI Number | 1316647050 |
|---|---|
| Provider Enumeration Date | 03/09/2023 |
| Last Update Date | 03/09/2023 |
| Medicare PECOS PAC ID | 2567829385 |
|---|---|
| Medicare Enrollment ID | O20230608002657 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316647050 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Nirva M Lindor-antoine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023061579 PECOS PAC ID: 8426066606 Enrollment ID: I20161220002564 |
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