Unknown Individual – Nurse Practitioner, NPI 1023087004
Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
350, North Clyde Morris Boulevard, Daytona Beach, Volusia County, Florida, 32114, United States
DAYTONA BEACH, FL 32114
Phone: (386) 238-3200
Fax: (386) 238-3264
Type: Location
Deerwood Park Boulevard, Jacksonville, Duval County, Florida, 33216, United States
JACKSONVILLE, FL 322560589
Phone: (866) 460-3567
Fax: (855) 632-8329
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32114)
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