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Organization
SHORES MEDICAL CENTER
Active
Organization
SHORES MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERALD WOODARD (OWNER)
(386) 767-9544
Entity
Organization
Contact information
Practice address
3512 S ATLANTIC BLVD, DAYTONA BEACH SHORES, FL 32118
(386) 767-9544
Mailing address
3512 S ATLANTIC AVE, DAYTONA BEACH SHORES, FL 32118-7639
(386) 767-9544
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
ARNP 3088302
FL
Other
Enumeration date
12/04/2014
Last updated
12/04/2014
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