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General NPI Number Information
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NPI Number | 1649485079
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Entity Type | Individual
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Provider Name | DAVID CHEESMAN DO
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Gender | Male
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4700 MILLENIA BLVD SUITE # 175
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City | ORLANDO
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State | FL
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Zip | 32839-6015
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Country | US
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Telephone | 321-354-5250
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 886
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City | DAYTONA BEACH
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State | FL
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Zip | 32115-0886
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Country | US
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Telephone | 321-354-5250
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 054187
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License Number State | FL
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