| Excellence Health Medical Clinics Llc | |
|
1630 Mason Ave Ste C Daytona Beach FL 32117-4503 | |
| (386) 238-9064 | |
| (386) 238-9063 |
| Full Name | Excellence Health Medical Clinics Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1630 Mason Ave Ste C, Daytona Beach, Florida |
| Authorized Official Name and Position | Husam Eddin (OWNER) |
| 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 Medical Clinics Llc 1630 Mason Ave Ste C Daytona Beach FL 32117-4503 Ph: (386) 238-9064 | Excellence Health Medical Clinics Llc 1630 Mason Ave Ste C Daytona Beach FL 32117-4503 Ph: (386) 238-9064 |
| NPI Number | 1902502875 |
|---|---|
| Provider Enumeration Date | 02/02/2023 |
| Last Update Date | 02/02/2023 |
| Medicare PECOS PAC ID | 7113457250 |
|---|---|
| Medicare Enrollment ID | O20250205001029 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902502875 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (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 | Kristin L Wulff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285771444 PECOS PAC ID: 5799876637 Enrollment ID: I20091007000274 |
| Provider Name | Radharani S Gollamudi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245287713 PECOS PAC ID: 0547271652 Enrollment ID: I20110701000152 |
| Provider Name | Sara R Schiffman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225571714 PECOS PAC ID: 7416222575 Enrollment ID: I20170929001093 |
| 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 | Heather Marie Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508467523 PECOS PAC ID: 7214380104 Enrollment ID: I20240126002534 |
| 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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