Individual
DANE HUGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
1150 RED JOHN DR, DAYTONA BEACH, FL 32124-1016
(800) 539-4228
Mailing address
150 MAGNOLIA AVE, DAYTONA BEACH, FL 32114-4304
(800) 539-4228
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN11004716
FL
Other
Enumeration date
12/13/2019
Last updated
12/13/2019
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