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General NPI Number Information
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NPI Number | 1871456343
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Entity Type | Organization
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Legal Business Name | PDC OF VOLUSIA LLC
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Dates
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Enumeration Date | 12/03/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 575 N CLYDE MORRIS BLVD STE B
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-2318
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Country | US
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Telephone | 386-217-6556
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Fax | 386-217-6539
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Provider Business Mailing Address
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Address Line | 101 S FEDERAL HWY # 56
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-2926
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Country | US
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Telephone | 386-217-6556
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Fax | 386-217-6539
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DR. NIKUL M PANCHAL
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Credential | DPM
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Telephone | 386-217-6556
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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