| Shores Medical Center | |
|
3512 S Atlantic Ave Daytona Beach Shores FL 32118-7639 | |
| (386) 767-9544 | |
| (386) 756-0501 |
| Full Name | Shores Medical Center |
|---|---|
| Speciality | Family Medicine |
| Location | 3512 S Atlantic Ave, Daytona Beach Shores, Florida |
| Authorized Official Name and Position | Gerald R Woodard (PRESIDENT) |
| Authorized Official Contact | 3867679544 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shores Medical Center 3512 S Atlantic Ave Daytona Beach Shores FL 32118-7639 Ph: (386) 767-9544 | Shores Medical Center 3512 S Atlantic Ave Daytona Beach Shores FL 32118-7639 Ph: (386) 767-9544 |
| NPI Number | 1114111440 |
|---|---|
| Provider Enumeration Date | 08/29/2007 |
| Last Update Date | 08/29/2007 |
| Medicare PECOS PAC ID | 9436115052 |
|---|---|
| Medicare Enrollment ID | O20041206000869 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114111440 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OS4717 (Florida) | Primary |
| Provider Name | Gerald R Woodard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700877388 PECOS PAC ID: 8426014044 Enrollment ID: I20041207000955 |
| Provider Name | Nancy S Mather |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891907671 PECOS PAC ID: 8820026826 Enrollment ID: I20050801000542 |
| Provider Name | Angela M Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811265572 PECOS PAC ID: 1052579455 Enrollment ID: I20120214000614 |
| Provider Name | Diane Marie Gellermann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265891816 PECOS PAC ID: 2365749371 Enrollment ID: I20160317002272 |
| Provider Name | Holly A Mulvey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639534159 PECOS PAC ID: 8123304565 Enrollment ID: I20170419000781 |
| Provider Name | Meagan Burgess |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891261863 PECOS PAC ID: 6103163787 Enrollment ID: I20190122001332 |
| Provider Name | Lauren A Girard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346690484 PECOS PAC ID: 0547549628 Enrollment ID: I20190529001705 |
| Provider Name | Tara James |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518433804 PECOS PAC ID: 9032446430 Enrollment ID: I20190807004113 |
Total Wellness & Healthy Aging Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2922 Sea Oats Cir, Daytona Beach Shores, FL 32118 Phone: 386-871-0675 Fax: 386-767-9085 | |
Total Wellness & Healthy Aging Foundation Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2922 Sea Oats Cir, Daytona Beach Shores, FL 32118 Phone: 386-871-4515 | |
Advowatch Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3704 Cardinal Blvd, Daytona Beach Shores, FL 32118 Phone: 386-256-2015 | |
Smc Rehab Services, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3512 S Atlantic Ave, Daytona Beach Shores, FL 32118 Phone: 386-767-9544 Fax: 386-767-9914 | |
Hassan Alkhatib Md Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2055 S Atlantic Ave Apt 1103, Daytona Beach Shores, FL 32118 Phone: 330-766-0682 Fax: 888-959-0682 |