Individual
DR. MARY JUNE DERBENWICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
350 N CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114-2733
(386) 238-3244
(386) 238-3269
Mailing address
350 N CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114-2733
(386) 238-3244
Taxonomy
Speciality
Code
Description
License number
State
2084V0102X
Vascular Neurology Physician
Primary
ME0028487
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1063405975
TRICARE
FL
01
—
64322
BCBS
FL
Enumeration date
08/25/2005
Last updated
06/23/2023
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