Organization
OUTREACH COMMUNITY CARE NETWORK, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORETTA JENNINGS (EXECUTIVE DIRECTOR)
(386) 255-5569
Entity
Organization
Contact information
Practice address
240 N FREDERICK AVE, SUITE D, DAYTONA BEACH, FL 32114-3400
(386) 255-5569
(386) 257-1245
Mailing address
240 N FREDERICK AVE, SUITE D, DAYTONA BEACH, FL 32114-3400
(386) 255-5569
(386) 257-1245
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
12473
FL
Other
Enumeration date
10/03/2013
Last updated
02/20/2014
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