Individual
DR. JOHN PENINGTON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
303 N CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114-2709
(386) 254-2285
(386) 425-1304
Mailing address
303 N CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114-2709
(386) 254-2285
(386) 425-1304
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME30791
FL
207Q00000X
Family Medicine Physician
ME0030791
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
066074400
—
FL
01
—
ME30791
STATE MEDICAL LICENSE
FL
Enumeration date
11/17/2006
Last updated
02/27/2016
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