MEDICARE: DR. KEVIN D. HUFFMAN D.O.

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
1	207Q00000X	Family Medicine Physician	OS 9066	FL

General Provider Information

NPI Number	:	1932196052
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEVIN D. HUFFMAN D.O.

Provider Business Mailing Address
First Line	:	PO BOX 1267
Second Line	:
City	:	NEW SMYRNA BEACH
State	:	FL
Zip	:	32170-1267
Country	:	US
Telephone Number	:	386-402-4250
Fax Number	:

Provider Business Practice Location Address
First Line	:	432 N PINE MEADOW DR
Second Line	:
City	:	DEBARY
State	:	FL
Zip	:	32713-2306
Country	:	US
Telephone Number	:	866-402-4250
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2005
Last Update Date	:	07/16/2021

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