Healthcare Provider Details

I. General information

NPI: 1639095722
Provider Name (Legal Business Name): TELE MEDS R US
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 BEVILLE RD STE 20
DAYTONA BEACH FL
32119-1503
US

IV. Provider business mailing address

132 W INTERNATIONAL SPEEDWAY BLVD STE 2013
DAYTONA BEACH FL
32114-4322
US

V. Phone/Fax

Practice location:
  • Phone: 386-871-3855
  • Fax:
Mailing address:
  • Phone: 386-871-3855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: CASSONDRA YVETTE HAWKINS
Title or Position: MANAGER
Credential: APRN
Phone: 386-871-3855