Healthcare Provider Details

I. General information

NPI: 1477596641
Provider Name (Legal Business Name): HALIFAX HEALTHCARE SYSTEMS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

431 KEECH STREET
DAYTONA BEACH FL
32114
US

IV. Provider business mailing address

431 KEECH STREET
DAYTONA BEACH FL
32114
US

V. Phone/Fax

Practice location:
  • Phone: 386-947-3553
  • Fax:
Mailing address:
  • Phone: 386-947-3553
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. ARVIN LEWIS
Title or Position: VPPBFS
Credential:
Phone: 386-254-4000