Organization
PRIMECARE AT TWIN LAKES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES D DUVA MD (PRESIDENT)
(386) 274-7800
Entity
Organization
Contact information
Practice address
1890 LPGA BLVD, SUITE 130, DAYTONA BEACH, FL 32117-7130
(386) 274-2212
(386) 274-1508
Mailing address
1890 LPGA BLVD, SUITE 130, DAYTONA BEACH, FL 32117-7130
(386) 274-2212
(386) 274-1508
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
10699
FL
Other
Enumeration date
08/26/2011
Last updated
08/26/2011
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