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General NPI Number Information
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NPI Number | 1144593724
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Entity Type | Organization
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Legal Business Name | DAYCLINIC INC.
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Dates
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Enumeration Date | 02/13/2012
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Last Update Date | 02/15/2012
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Provider Practice Location Address
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Address Line | 4722 VAN BUREN ST
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City | HOLLYWOOD
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State | FL
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Zip | 33021-7246
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Country | US
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Telephone | 276-252-7007
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Fax |
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Provider Business Mailing Address
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Address Line | 251 SAINT JOHNS CIR
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City | MARTINSVILLE
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State | VA
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Zip | 24112-6075
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Country | US
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Telephone | 276-252-7007
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. AYOKUNLE O FATADE
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Credential | D.O,
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Telephone | 276-252-7007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | OS11475
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License Number State | FL
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