| Urgent Care & Family Practice Center | |
|
405 North Clyde Morris Blvd Daytona Beach FL 32114-2730 | |
| (386) 235-8731 | |
| (386) 269-9555 |
| Full Name | Urgent Care & Family Practice Center |
|---|---|
| Speciality | Family Medicine |
| Location | 405 North Clyde Morris Blvd, Daytona Beach, Florida |
| Authorized Official Name and Position | Ejaz Ahmed (PRESIDENT) |
| Authorized Official Contact | 3862358731 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Urgent Care & Family Practice Center 3848 Calliope Ave Port Orange FL 32129-6025 Ph: (386) 235-8731 | Urgent Care & Family Practice Center 405 North Clyde Morris Blvd Daytona Beach FL 32114-2730 Ph: (386) 235-8731 |
| NPI Number | 1245636042 |
|---|---|
| Provider Enumeration Date | 11/06/2014 |
| Last Update Date | 11/06/2014 |
| Medicare PECOS PAC ID | 5395056659 |
|---|---|
| Medicare Enrollment ID | O20150612002214 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245636042 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME95557 (Florida) | Primary |
| Provider Name | Ejaz Ahmed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003841081 PECOS PAC ID: 6507957586 Enrollment ID: I20080528000111 |
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