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General NPI Number Information
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NPI Number | 1164882726
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Entity Type | Organization
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Legal Business Name | DARREN PAYNE, M.D., LLC
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Dates
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Enumeration Date | 02/25/2016
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Last Update Date | 02/25/2016
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Provider Practice Location Address
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Address Line | 3402 N LECANTO HWY
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City | BEVERLY HILLS
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State | FL
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Zip | 34465-3570
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Country | US
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Telephone | 850-240-2205
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 641538
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City | BEVERLY HILLS
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State | FL
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Zip | 34464-1538
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Country | US
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Telephone | 850-240-2205
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. DARREN PAYNE
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Credential | M.D.
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Telephone | 850-240-2205
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | ME88113
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License Number State | FL
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