Organization
CENTURY CLINICAL FAMILY MEDICINE, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS L GASKIN JR. CFP (CFO)
(386) 274-4750
Entity
Organization
Contact information
Practice address
1410 LPGA BLVD, STE. 140, DAYTONA BEACH, FL 32117-5115
(386) 274-4750
Mailing address
1410 LPGA BLVD, STE. 140, DAYTONA BEACH, FL 32117-5115
(386) 274-4750
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
363LF0000X
Family Nurse Practitioner
ARNP9211084
FL
Other
Enumeration date
09/30/2009
Last updated
11/04/2009
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