Healthcare Provider Details
I. General information
NPI: 1710874193
Provider Name (Legal Business Name): DAYLIGHT PEDIATRICS INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/19/2025
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1688 W GRANADA BLVD STE 1A
ORMOND BEACH FL
32174-1818
US
IV. Provider business mailing address
1688 W GRANADA BLVD STE 1A
ORMOND BEACH FL
32174-1818
US
V. Phone/Fax
- Phone: 386-425-4414
- Fax: 386-615-8466
- Phone: 386-425-4414
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JAIME
E
QUINTEROS
Title or Position: PRESIDENT
Credential: MD
Phone: 386-425-4414