| D.H. Medical, LLC | |
|
735 Dunlawton Ave Port Orange FL 32127-9226 | |
| (888) 808-0488 | |
| (386) 872-4232 |
| Full Name | D.H. Medical, LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 735 Dunlawton Ave, Port Orange, Florida |
| Authorized Official Name and Position | David a Heise (OWNER) |
| Authorized Official Contact | 3862351489 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| D.H. Medical, LLC 735 Dunlawton Ave Port Orange FL 32127-9226 Ph: (888) 808-0488 | D.H. Medical, LLC 735 Dunlawton Ave Port Orange FL 32127-9226 Ph: (888) 808-0488 |
| NPI Number | 1477855815 |
|---|---|
| Provider Enumeration Date | 11/17/2010 |
| Last Update Date | 10/15/2024 |
| Certification Date | 10/15/2024 |
| Medicare PECOS PAC ID | 6103014618 |
|---|---|
| Medicare Enrollment ID | O20101228000869 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477855815 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME83299 (Florida) | Primary |
| Provider Name | Samuel S Woociker |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1912971979 PECOS PAC ID: 0749172682 Enrollment ID: I20040326000219 |
| Provider Name | David a Heise |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740353465 PECOS PAC ID: 8022009943 Enrollment ID: I20040520000133 |
| Provider Name | Alison Gettman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760665855 PECOS PAC ID: 7113940289 Enrollment ID: I20060104000820 |
| Provider Name | James P Marcum |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1801811120 PECOS PAC ID: 5799781589 Enrollment ID: I20061019000036 |
| Provider Name | Sean M Kaufman |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1255305637 PECOS PAC ID: 7315111457 Enrollment ID: I20111129000562 |
| Provider Name | Sara E Blackstone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336547298 PECOS PAC ID: 5799009726 Enrollment ID: I20150122002672 |
| Provider Name | Adrianna a Weber |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1801343702 PECOS PAC ID: 7113295759 Enrollment ID: I20170622001762 |
| Provider Name | Jennifer Zerrudo Traverso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699294496 PECOS PAC ID: 8426316498 Enrollment ID: I20171220002093 |
| Provider Name | Traci Lynn Zimmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033571930 PECOS PAC ID: 8426319609 Enrollment ID: I20180305000455 |
| Provider Name | Bruce L Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023500881 PECOS PAC ID: 1759713290 Enrollment ID: I20191121000915 |
| Provider Name | Theodore Bens |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1669562815 PECOS PAC ID: 8820020548 Enrollment ID: I20200630001620 |
| Provider Name | Rachel Annette Tax |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356948871 PECOS PAC ID: 8729484977 Enrollment ID: I20210914000285 |
| Provider Name | Leticia Lee Pappas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013522242 PECOS PAC ID: 0345647467 Enrollment ID: I20210916000547 |
| Provider Name | Krystal Marie Disantis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033693288 PECOS PAC ID: 2062759657 Enrollment ID: I20211111001456 |
| Provider Name | Timothy Byrd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932726122 PECOS PAC ID: 3779976840 Enrollment ID: I20220214000962 |
| Provider Name | Cassie Harrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710629852 PECOS PAC ID: 0345621272 Enrollment ID: I20220722001822 |
| Provider Name | Julia Malysh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356075766 PECOS PAC ID: 3971987488 Enrollment ID: I20220901002142 |
| Provider Name | Pamela Lawawen Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215526900 PECOS PAC ID: 7810371143 Enrollment ID: I20220905000126 |
| Provider Name | De'la Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356122634 PECOS PAC ID: 6204284557 Enrollment ID: I20231127001903 |
| Provider Name | Mekeshia Shanquietta Sanchez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548000789 PECOS PAC ID: 8325580111 Enrollment ID: I20240607002528 |
| Provider Name | Amanda Faye Adkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104007376 PECOS PAC ID: 3375843303 Enrollment ID: I20241008003227 |
| Provider Name | Alicia Arkell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255994950 PECOS PAC ID: 1557895679 Enrollment ID: I20241112004595 |
| Provider Name | Debbie Hinson Fisher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053118240 PECOS PAC ID: 7810410115 Enrollment ID: I20250327001518 |
| Provider Name | Candice Paff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477378404 PECOS PAC ID: 5991229957 Enrollment ID: I20250411000432 |
| Provider Name | Dina Bitar Bowen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356693550 PECOS PAC ID: 8527557719 Enrollment ID: I20251028004036 |
| Provider Name | Shayla Wyche |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689559254 PECOS PAC ID: 1355822701 Enrollment ID: I20260224001153 |
| Provider Name | Marcy Starling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639990559 PECOS PAC ID: 6608357538 Enrollment ID: I20260227002004 |
| Provider Name | Barbie Mcneill Johnston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578243622 PECOS PAC ID: 7517440597 Enrollment ID: I20260309003275 |
| Provider Name | Elian Pernas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568298206 PECOS PAC ID: 7315421773 Enrollment ID: I20260324002129 |
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