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Organization

ORTHOPAEDIC CLINIC OF DAYTONA BEACH PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ALBERT W. GILLESPY MD (PRESIDENT)
(386) 255-4596
Entity
Organization

Contact information

Practice address
1865 LPGA BLVD, DAYTONA BEACH, FL 32117-7108
(386) 255-4596
(386) 258-3561
Mailing address
1865 LPGA BLVD, DAYTONA BEACH, FL 32117-7108
(386) 255-4596
(386) 258-3561

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036096100
FL
05
036096101
FL
05
036096102
FL
05
036096103
FL
05
036096104
FL
05
036096105
FL
05
104741300
FL
05
105512000
FL
05
105512600
FL
05
106515900
FL
Enumeration date
01/11/2006
Last updated
08/05/2025
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