| Your Doctor's Office, Inc. | |
|
800 S Nova Rd Suite A Ormond Beach FL 32174-9048 | |
| (386) 676-0505 | |
| (386) 676-0788 |
| Full Name | Your Doctor's Office, Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 800 S Nova Rd, Ormond Beach, Florida |
| Authorized Official Name and Position | Dannie E. Buck (PRESIDENT) |
| Authorized Official Contact | 3866760505 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Your Doctor's Office, Inc. Po Box 730607 Ormond Beach FL 32173-0607 Ph: (386) 676-0505 | Your Doctor's Office, Inc. 800 S Nova Rd Suite A Ormond Beach FL 32174-9048 Ph: (386) 676-0505 |
| NPI Number | 1982985826 |
|---|---|
| Provider Enumeration Date | 09/06/2011 |
| Last Update Date | 09/06/2011 |
| Medicare PECOS PAC ID | 8022281294 |
|---|---|
| Medicare Enrollment ID | O20111103000294 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982985826 | NPI | - | NPPES |
| 371526400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME0062671 (Florida) | Primary |
| Provider Name | Dannie E Buck |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366525750 PECOS PAC ID: 4183897358 Enrollment ID: I20111103000337 |
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