Organization
MEDALLION HEALTH CARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KEONA LATOSHA SLATER (OWNER)
(386) 405-4155
Entity
Organization
Contact information
Practice address
308 S. MARTIN LUTHER KING BLVD., STE. 113, DAYTONA BEACH, FL 32114
(386) 405-4155
Mailing address
815 KOTTLE CIR S, DAYTONA BEACH, FL 32114-4719
(386) 405-4155
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
07/18/2008
Last updated
07/18/2008
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