| Richard Daniel Potts Md Pllc | |
|
26 N Beach St Ste C Ormond Beach FL 32174-5656 | |
| (386) 506-9994 | |
| (386) 281-5870 |
| Full Name | Richard Daniel Potts Md Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 26 N Beach St Ste C, Ormond Beach, Florida |
| Authorized Official Name and Position | Richard Daniel Potts (OWNER) |
| Authorized Official Contact | 3865099994 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Richard Daniel Potts Md Pllc 125 Ocean Shore Blvd Ormond Beach FL 32176-5734 Ph: (386) 506-9994 | Richard Daniel Potts Md Pllc 26 N Beach St Ste C Ormond Beach FL 32174-5656 Ph: (386) 506-9994 |
| NPI Number | 1689994303 |
|---|---|
| Provider Enumeration Date | 06/03/2010 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 5496870867 |
|---|---|
| Medicare Enrollment ID | O20100909000448 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689994303 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME99225 (Florida) | Primary |
| Provider Name | Richard D Potts |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790987147 PECOS PAC ID: 4486738978 Enrollment ID: I20080223000054 |
| Provider Name | Teresa K Velez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871880732 PECOS PAC ID: 4688800428 Enrollment ID: I20131126001143 |
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Mark W. Lastarza, M.d., Pa. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 335 Clyde Morris Blvd, Suite 290, Ormond Beach, FL 32174 Phone: 386-672-3219 Fax: 386-672-3160 | |
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