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General NPI Number Information
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NPI Number | 1205399060
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Entity Type | Organization
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Legal Business Name | DAYTONA PEDIATRICS
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Dates
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Enumeration Date | 04/09/2019
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Last Update Date | 04/09/2019
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Provider Practice Location Address
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Address Line | 909 BIG TREE RD
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City | SOUTH DAYTONA
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State | FL
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Zip | 32119-2517
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Country | US
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Telephone | 386-676-0255
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Fax | 386-676-2555
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Provider Business Mailing Address
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Address Line | 67 COQUINA RIDGE WAY
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City | ORMOND BEACH
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State | FL
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Zip | 32174-1812
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Country | US
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Telephone | 386-366-4873
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Fax | 386-676-2555
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Authorized Official
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Title or Position | OWNER
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Name | DR. AMAR N SINGH
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Credential | MD
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Telephone | 386-366-4873
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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