Provider Demographics
NPI:1952420457
Name:DAYTONA BEACH HAND CLINIC INC
Entity Type:Organization
Organization Name:DAYTONA BEACH HAND CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:STRAUSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-258-8080
Mailing Address - Street 1:3635 S CLYDE MORRIS BLVD
Mailing Address - Street 2:ST. 300
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32129-2300
Mailing Address - Country:US
Mailing Address - Phone:386-258-8080
Mailing Address - Fax:386-258-8177
Practice Address - Street 1:3635 S CLYDE MORRIS BLVD
Practice Address - Street 2:ST. 300
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32129-2300
Practice Address - Country:US
Practice Address - Phone:386-258-8080
Practice Address - Fax:386-258-8177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK7982Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
FL0941450001Medicare NSC