Provider Demographics
NPI:1770393084
Name:EASY ACCESS OF DAYTONA, INC.
Entity type:Organization
Organization Name:EASY ACCESS OF DAYTONA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARBIENER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:386-295-4992
Mailing Address - Street 1:1890 LPGA BLVD STE 160
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32117-7138
Mailing Address - Country:US
Mailing Address - Phone:386-868-7012
Mailing Address - Fax:
Practice Address - Street 1:421 S KEECH ST
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-4623
Practice Address - Country:US
Practice Address - Phone:386-868-7012
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EASY ACCESS OF DAYTONA, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-01-09
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty