Organization

Kemshol Medical Center Pa

Clinic/Center in Daytona Beach, FL(View on Map)

Legal Business Name

Kemshol Medical Center Pa

NPI Number

1023213469

NPI Type

Organization

Enumeration Date

06/16/2007

Specialties

(Taxonomies)

Code

261Q00000X

Primary Taxonomy

Yes

Contact
Information

Purpose

Mailing
Location

Address

984 ORANGE AVE
984 ORANGE AVE

City

Daytona Beach
Daytona Beach

State

FL
FL

Postal Code

32114-4667
32114-4667

Country

US
US

Telephone Number

(386) 226-3008
(386) 226-3008

Authorized Official

Name

Dr. Olubukunola Thomas

Title or Position

PRESIDENT

Telephone Number

(407) 756-4541

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 10/27/2007

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