| Century Clinical Family Medicine, Llc. | |
|
1410 Lpga Blvd Ste. 140 Daytona Beach FL 32117-5115 | |
| (386) 274-4750 | |
| Not Available |
| Full Name | Century Clinical Family Medicine, Llc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1410 Lpga Blvd, Daytona Beach, Florida |
| Authorized Official Name and Position | Thomas L Gaskin (CFO) |
| Authorized Official Contact | 3862744750 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Century Clinical Family Medicine, Llc. 1410 Lpga Blvd Ste. 140 Daytona Beach FL 32117-5115 Ph: (386) 274-4750 | Century Clinical Family Medicine, Llc. 1410 Lpga Blvd Ste. 140 Daytona Beach FL 32117-5115 Ph: (386) 274-4750 |
| NPI Number | 1710211289 |
|---|---|
| Provider Enumeration Date | 09/30/2009 |
| Last Update Date | 11/04/2009 |
| Medicare PECOS PAC ID | 0042358996 |
|---|---|
| Medicare Enrollment ID | O20091112000626 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710211289 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | ARNP9211084 (Florida) | Secondary |
| Provider Name | Blanca C Luna |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891730974 PECOS PAC ID: 2062571946 Enrollment ID: I20081106000662 |
| Provider Name | Tina Gail Gaskin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235463266 PECOS PAC ID: 5395883243 Enrollment ID: I20091112000636 |
| Provider Name | Aaron Porter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821250721 PECOS PAC ID: 7012164064 Enrollment ID: I20150224000788 |
| Provider Name | Michelle Guirand |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609373935 PECOS PAC ID: 7012271489 Enrollment ID: I20180510002615 |
| Provider Name | Humberto Paez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992204291 PECOS PAC ID: 2163777608 Enrollment ID: I20180625000682 |
| Provider Name | Brittany Canidate |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457133225 PECOS PAC ID: 5799132221 Enrollment ID: I20231106001660 |
Primecare Acquisition Family Practice Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1890 Lpga Blvd Ste 130, Daytona Beach, FL 32117 Phone: 386-274-2212 Fax: 386-274-1508 | |
Alexandra Crossman Md Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 303 N Clyde Morris Blvd, Daytona Beach, FL 32114 Phone: 386-589-5741 | |
Kemshol Medical Center Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 984 Orange Ave, Daytona Beach, FL 32114 Phone: 386-226-3008 Fax: 386-226-3044 | |
Adventist Health System/sunbelt, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1014 W International Speedway Blvd, Daytona Beach, FL 32114 Phone: 407-200-2300 Fax: 407-200-1353 | |
Primary Healthcare Alliance Foundation Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1445 Dunn Ave Ste B, Daytona Beach, FL 32114 Phone: 386-238-9527 Fax: 386-492-5059 | |
Volusia Hospitalists Plc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 301 Memorial Medical Pkwy, Daytona Beach, FL 32117 Phone: 386-676-0255 Fax: 386-676-2555 | |
Premier Infectious Disease Consultants Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 303 N Clyde Morris Blvd, Daytona Beach, FL 32114 Phone: 636-333-4500 |