Individual
DR. SIDNEY POSSICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
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
19498
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
64266Z
MEDICARE PTAN
FL
Enumeration date
09/16/2006
Last updated
02/26/2010
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