Individual
DR. LORETHA KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
143 EXECUTIVE CIR, DAYTONA BEACH, FL 32114-1180
(772) 233-9515
Mailing address
6101 BLUE LAGOON DR STE 400, MIAMI, FL 33126-2051
(305) 500-2000
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
OS8310
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
279101300
—
FL
Enumeration date
02/26/2007
Last updated
10/13/2020
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