Organization
BLACKSHEEP MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL A SEEDOR (MGMR)
(386) 256-3977
Entity
Organization
Contact information
Practice address
1425 HAND AVE, SUITE L, ORMOND BEACH, FL 32174-1135
(386) 256-3977
(386) 872-5004
Mailing address
1425 HAND AVE, SUITE L, ORMOND BEACH, FL 32174-1135
(386) 256-3977
(386) 872-5004
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
11/18/2013
Last updated
11/18/2013
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