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General NPI Number Information
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NPI Number | 1790238459
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Entity Type | Organization
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Legal Business Name | EMERGENCY MEDICINE PROFESSIONALS PA
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Dates
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Enumeration Date | 07/29/2016
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 5811 S WILLIAMSON BLVD
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City | PORT ORANGE
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State | FL
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Zip | 32128-6101
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Country | US
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Telephone | 386-672-4161
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Fax | 386-274-7801
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Provider Business Mailing Address
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Address Line | 222 S PENINSULA DR
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City | DAYTONA BEACH
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State | FL
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Zip | 32118-4422
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Country | US
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Telephone | 386-310-2160
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Fax | 386-310-2106
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHARLES D DUVA
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Credential | MD
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Telephone | 386-310-2160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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