Organization
EAST COAST BARIATRICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY A. MYERS M.D. (CHIEF EXECUTIVE OFFICER)
(386) 676-7100
Entity
Organization
Contact information
Practice address
201 N CLYDE MORRIS BLVD, SUITE 100 A, DAYTONA BEACH, FL 32114-2724
(386) 676-7130
(386) 676-7125
Mailing address
PO BOX 9671, DAYTONA BEACH, FL 32120-9671
(386) 676-7130
(386) 676-7125
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001C8
BCBS
FL
01
—
1932428372
TRICARE
FL
01
—
943055
AETNA
FL
01
—
DR2599
RAILROAD MEDICARE
FL
Enumeration date
05/25/2010
Last updated
12/30/2013
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