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1063426823

NPI Code Detail

MEDICARE: MEMORIAL HEALTH SYSTEMS INC

MEDICARE: MEMORIAL HEALTH SYSTEMS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0404X	Cardiac Rehabilitation Clinic/Center
2	282N00000X	General Acute Care Hospital	4201	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1063426823	OTHER	FL	AETNA HMO
3	1063426823	OTHER	FL	AETNA PPO
4	1063426823	OTHER	FL	UHC
5	334	OTHER	FL	BLUE CROSS
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063426823
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEMORIAL HEALTH SYSTEMS INC

Provider Business Mailing Address
First Line	:	770 W GRANADA BLVD STE 203
Second Line	:
City	:	ORMOND BEACH
State	:	FL
Zip	:	32174-5179
Country	:	US
Telephone Number	:	386-231-4610
Fax Number	:	386-231-3342

Provider Business Practice Location Address
First Line	:	301 MEMORIAL MEDICAL PKWY
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32117-5167
Country	:	US
Telephone Number	:	386-231-6000
Fax Number	:	386-231-3342

Authorized Official
Title or Position	:	CFO
Name	:	FRANCIS C OWENS
Credential	:
Telephone Number	:	606-594-0705

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	02/16/2026

Similar Medicare Providers

1487238374 — JULIA KERBS
Practice Location Address:

301 MEMORIAL MEDICAL PKWY
DAYTONA BEACH, FL
32117-5167

Practice Phone: 386-231-6000
Practice Fax:

1346249315 — STEFAN G HUMPHRIES M.D.
Practice Location Address:

301 MEMORIAL MEDICAL PKWY
DAYTONA BEACH, FL
32117-5167

Practice Phone: 386-231-6000
Practice Fax:

1790786721 — DR. CHRISTINA CHANDLER MD
Practice Location Address:

301 MEMORIAL MEDICAL PKWY
DAYTONA BEACH, FL
32117-5167

Practice Phone: 386-231-6000
Practice Fax: 410-710-8587

1225026503 — LAURA ANNE STONAKER PA.C
Practice Location Address:

301 MEMORIAL MEDICAL PKWY
DAYTONA BEACH, FL
32117-5167

Practice Phone: 386-231-1500
Practice Fax:

1972588788 — KATHLEEN ANN WILLIAMS MD
Practice Location Address:

301 MEMORIAL MEDICAL PKWY
DAYTONA BEACH, FL
32117-5167

Practice Phone: 386-231-1091
Practice Fax: 386-231-1092

1629055447 — CINDY J PORTNER DO
Practice Location Address:

301 MEMORIAL MEDICAL PKWY
DAYTONA BEACH, FL
32117-5167

Practice Phone: 386-231-6000
Practice Fax:

Directions to “MEMORIAL HEALTH SYSTEMS INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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