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NPI Code Detail

MEDICARE: EMERGENCY MEDICINE PROFESSIONALS PA

MEDICARE: EMERGENCY MEDICINE PROFESSIONALS PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
239701OTHERFLBLUE CROSS OF FLORIDA
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205880853
Entity Type Code : Organization
Provider Name (Legal Business Name) : EMERGENCY MEDICINE PROFESSIONALS PA
Provider Business Mailing Address
First Line : 222 S PENINSULA DR
Second Line :
City : DAYTONA BEACH
State : FL
Zip : 32118-4422
Country : US
Telephone Number : 386-310-2160
Fax Number : 386-310-2106
Provider Business Practice Location Address
First Line : 701 W PLYMOUTH AVE
Second Line :
City : DELAND
State : FL
Zip : 32720-3236
Country : US
Telephone Number : 386-734-3220
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : CHARLES D DUVA
Credential : MD
Telephone Number : 386-310-2160
Provider Enumeration Date : 05/19/2006
Last Update Date : 01/22/2025

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Directions to “EMERGENCY MEDICINE PROFESSIONALS PA ” Practice Location

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