Individual
JOEL EVERETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1130 BEVILLE RD, DAYTONA BEACH, FL 32114-5743
(386) 253-6051
Mailing address
303 N CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114-2709
(386) 425-0141
(386) 226-4577
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA0003272
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1275640997
GROUP NPI
FL
01
—
94854
BCBS GROUP#
FL
Enumeration date
05/21/2007
Last updated
08/19/2019
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