Organization
SIDNEY POSSICK M.D.,P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SIDNEY POSSICK M.D. (PRESIDENT)
(386) 252-5578
Entity
Organization
Contact information
Practice address
655 N CLYDE MORRIS BLVD, SUITE B, DAYTONA BEACH, FL 32114-2321
(386) 252-5578
(386) 257-3660
Mailing address
655 N CLYDE MORRIS BLVD, SUITE B, DAYTONA BEACH, FL 32114-2321
(386) 252-5578
(386) 257-3660
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
ME19498
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CM988A
MEDICARE PTAN
FL
Enumeration date
12/02/2009
Last updated
01/26/2010
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