| Thrivewell Lifestyle Medicine Pa | |
|
817 Bama Breeze Dr Daytona Beach FL 32124-3799 | |
| (386) 488-1449 | |
| Not Available |
| Full Name | Thrivewell Lifestyle Medicine Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 817 Bama Breeze Dr, Daytona Beach, Florida |
| Authorized Official Name and Position | Gary Pitts (OWNER) |
| Authorized Official Contact | 3864881449 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thrivewell Lifestyle Medicine Pa 817 Bama Breeze Dr Daytona Beach FL 32124-3799 Ph: () - | Thrivewell Lifestyle Medicine Pa 817 Bama Breeze Dr Daytona Beach FL 32124-3799 Ph: (386) 488-1449 |
| NPI Number | 1780407254 |
|---|---|
| Provider Enumeration Date | 11/04/2024 |
| Last Update Date | 11/04/2024 |
| Medicare PECOS PAC ID | 7113453762 |
|---|---|
| Medicare Enrollment ID | O20241206000732 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780407254 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Gary Pitts |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467428318 PECOS PAC ID: 1658472329 Enrollment ID: I20210222000014 |
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