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Organization
NORTHWEST FAMILY HEALTH CENTER II, LLC
Active
Organization
NORTHWEST FAMILY HEALTH CENTER II, LLC
Active
Parent organization
NORTHWEST FAMILY HEALTH CENTER
Other names
NORTHWEST FAMILY HEALTH CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTHWEST FAMILY HEALTH CENTER
Authorized official
DR. GARRY BEAUBRUN ANTOINE MD (PRESIDENT & CEO)
(845) 821-1291
Entity
Organization
Contact information
Practice address
1630 MASON AVE STE B, DAYTONA BEACH, FL 32117-4503
(386) 888-4006
(386) 675-6610
Mailing address
PO BOX 951306, LAKE MARY, FL 32795-1306
(386) 888-4006
(386) 675-6610
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/09/2023
Last updated
03/09/2023
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