Organization
ORMOND PEDIATRICS, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER MELISSA DANVER (OFFICE MANAGER)
(386) 673-2770
Entity
Organization
Contact information
Practice address
725 W. GRANADA BLVD. ST 1, ORMOND BEACH, FL 32174
(386) 673-2770
(386) 673-2760
Mailing address
725 W. GRANADA BLVD. ST 1, ORMOND BEACH, FL 32174
(386) 673-2770
(386) 673-2760
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007381100
—
FL
Enumeration date
02/08/2008
Last updated
11/16/2020
Update your record
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