Organization
ELOISA G. DIMAYUGA, MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELOISA G DIMAYUGA MD (PRESIDENT)
(386) 451-5940
Entity
Organization
Contact information
Practice address
303 N CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114-2709
(386) 451-5940
Mailing address
226 N NOVA RD STE 320, ORMOND BEACH, FL 32174-5124
(386) 451-5940
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40553
MEDICARE GROUP NUMBER
—
Enumeration date
02/08/2008
Last updated
11/28/2017
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