Healthcare Provider Details

I. General information

NPI: 1942624721
Provider Name (Legal Business Name): EMERGENCY MEDICINE PROFESSIONALS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2014
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 MEMORIAL MEDICAL PKWY
PALM COAST FL
32164-5980
US

IV. Provider business mailing address

222 S PENINSULA DR
DAYTONA BEACH FL
32118-4422
US

V. Phone/Fax

Practice location:
  • Phone: 386-586-2000
  • Fax: 386-274-7801
Mailing address:
  • Phone: 386-310-2160
  • Fax: 386-310-2106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CHARLES D DUVA
Title or Position: PRESIDENT
Credential: MD
Phone: 386-310-2160