| Shekinah Health & Wellness Center, Llc | |
|
305 Clyde Morris Blvd Ormond Beach FL 32174-8181 | |
| (561) 317-8454 | |
| Not Available |
| Full Name | Shekinah Health & Wellness Center, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 305 Clyde Morris Blvd, Ormond Beach, Florida |
| Authorized Official Name and Position | Moline J Blanc (OWNER) |
| Authorized Official Contact | 5613178454 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shekinah Health & Wellness Center, Llc 305 Clyde Morris Blvd Ormond Beach FL 32174-8181 Ph: (561) 317-8454 | Shekinah Health & Wellness Center, Llc 305 Clyde Morris Blvd Ormond Beach FL 32174-8181 Ph: (561) 317-8454 |
| NPI Number | 1346719812 |
|---|---|
| Provider Enumeration Date | 11/14/2018 |
| Last Update Date | 11/15/2018 |
| Medicare PECOS PAC ID | 1557602562 |
|---|---|
| Medicare Enrollment ID | O20190401000192 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346719812 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363AM0700X | Physician Assistant - Medical | (* (Not Available)) | Secondary |
| Provider Name | Orjanette Marie Cooper-bryant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013034388 PECOS PAC ID: 4789088055 Enrollment ID: I20210809001982 |
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James E Mcdonnell Md Plc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 305 Clyde Morris Blvd, Suite 130, Ormond Beach, FL 32174 Phone: 386-677-6727 Fax: 386-677-3211 | |
Mark W. Lastarza, M.d., Pa. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 335 Clyde Morris Blvd, Suite 290, Ormond Beach, FL 32174 Phone: 386-672-3219 Fax: 386-672-3160 | |
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