Provider Demographics
NPI:1629415328
Name:DAYBREAK PEDIATRIC HOUSECALLS, P.A.
Entity Type:Organization
Organization Name:DAYBREAK PEDIATRIC HOUSECALLS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:CHRISTINA
Authorized Official - Last Name:HAUKOOS
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:352-359-2757
Mailing Address - Street 1:PO BOX 164
Mailing Address - Street 2:
Mailing Address - City:MOUNT DORA
Mailing Address - State:FL
Mailing Address - Zip Code:32756-0164
Mailing Address - Country:US
Mailing Address - Phone:352-359-2757
Mailing Address - Fax:
Practice Address - Street 1:925 NORTHSIDE DR
Practice Address - Street 2:
Practice Address - City:MOUNT DORA
Practice Address - State:FL
Practice Address - Zip Code:32757-2610
Practice Address - Country:US
Practice Address - Phone:352-359-2757
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-04
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3084852261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service