Healthcare Provider Details

I. General information

NPI: 1437394459
Provider Name (Legal Business Name): AMAND DAVID BATSON LPN/AUDIO TECH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2008
Last Update Date: 12/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

551 NATIONAL HEALTH CARE DR
DAYTONA BEACH FL
32114-1495
US

IV. Provider business mailing address

551 NATIONAL HEALTH CARE DR
DAYTONA BEACH FL
32114-1495
US

V. Phone/Fax

Practice location:
  • Phone: 386-323-7500
  • Fax: 386-323-7570
Mailing address:
  • Phone: 386-323-7500
  • Fax: 386-323-7570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberPN841221
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: