| Excellence Health Care At Home, Llc | |
|
1630 Mason Ave Ste C Daytona Beach FL 32117-4503 | |
| (386) 238-9064 | |
| Not Available |
| Full Name | Excellence Health Care At Home, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1630 Mason Ave Ste C, Daytona Beach, Florida |
| Authorized Official Name and Position | Husam Eddin (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 3862389064 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Excellence Health Care At Home, Llc 1630 Mason Ave Ste C Daytona Beach FL 32117-4503 Ph: () - | Excellence Health Care At Home, Llc 1630 Mason Ave Ste C Daytona Beach FL 32117-4503 Ph: (386) 238-9064 |
| NPI Number | 1336906080 |
|---|---|
| Provider Enumeration Date | 02/29/2024 |
| Last Update Date | 02/29/2024 |
| Medicare PECOS PAC ID | 4183153455 |
|---|---|
| Medicare Enrollment ID | O20250131000425 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336906080 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Husam E Eddin |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1629082607 PECOS PAC ID: 7113945874 Enrollment ID: I20051110000748 |
| Provider Name | Delayna Siqueira |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285390328 PECOS PAC ID: 7315337300 Enrollment ID: I20211207000121 |
| Provider Name | Cindy Lynne Perdue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366103236 PECOS PAC ID: 0244466118 Enrollment ID: I20220126002981 |
| Provider Name | Kelli Knight Overturf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902664568 PECOS PAC ID: 1951843077 Enrollment ID: I20240605000013 |
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