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Memorial Health Systems Inc

Organization Active NPI Clinical Medical Laboratory · Daytona Beach, FL

NPI 1104696178 · NPPES record last updated Jan 8, 2024

Key facts

NPI
1104696178
Entity type
Organization (NPI type 2)
Primary specialty
Clinical Medical Laboratory 291U00000X
Legal business name
MEMORIAL HEALTH SYSTEMS INC
Practice address
301 Memorial Medical Pkwy
Daytona Beach, FL 32117-5167
Phone
(386) 231-6000
NPI assigned
Jan 2, 2024
Organization subpart
Yes
Parent organization (as reported)
MEMORIAL HEALTH SYSTEMS INC

Authorized official

Name
Cory Douglas Domayer
Title
Cfo
Phone
(386) 586-4200

Owners & managing parties with NPI records 5

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Corporate family (same tax ID) 7

Organizations that report the same tax identification number in the National Provider Directory.

Facilities connected through Provider of Services related, parent or unit certification numbers.

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 1,400

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 1,400

Medicare Care Compare: Hospital

Listed as
Adventhealth Daytona Beach CCN 100068
Overall star rating
★★★★★ 5 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Church
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0665348Adventhealth Lab
301 Memorial Medical Pkwy, Daytona Beach, FL 32117		AccreditationFeb 27, 2027
10D2009123Adventhealth Lab
301 Memorial Medical Pkwy, Daytona Beach, FL 32117		Certificate of waiverJun 24, 2028

Medicare participation

Medicare fee-for-service enrollment
Enrolled in FL

Hospital certification: CCN 100068

Legal name
MEMORIAL HEALTH SYSTEMS INC
Doing business as
ADVENTHEALTH DAYTONA BEACH
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
May 6, 1993
Beds
362
Ownership / control type
Church
Most recent change of ownership
Nov 11, 1999 (5 total)
Organization structure
Corporation · Non-profit
Incorporated
Aug 18, 1961 in FL
Enrollment address
301 Memorial Medical Pkwy
Daytona Beach, FL 32117-5167
Hospital subgroups
General, Acute care, Rehabilitation unit

All disclosed owners & managing parties 34

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Ketul R Patel
Individual 		Corporate Director
Director		 Jan 1, 2023
Debora H Thomas
Individual 		Corporate Officer
Assistant Secretary		 Aug 24, 2023
Corporate Director
Director		 Aug 24, 2023
Philip Maroney
Individual 		Corporate Director
Director		 Sep 17, 2020
Douglas Hilliard
Individual 		Corporate Officer
Asst Secretary		 Aug 21, 2025
John J Adams
Individual 		Corporate Director
Director		 Feb 21, 2013
Gloria Ceballos
Individual 		Corporate Director
Director		 Aug 17, 2023
Jeffrey Graff
Individual 		Corporate Officer
Assistant Secretary		 Sep 11, 2014
Meetesh S Desai
Individual 		Corporate Director
Director		 Feb 18, 2021
Diane Godfrey
Individual 		Corporate Officer
Asst Secretary		 Dec 11, 2025
Robert Deininger
Individual 		Corporate Officer
Asst Secretary, Chair		 Jun 13, 2025
Corporate Director
Director		 Jun 13, 2025
Andrea Hooper
Individual 		Corporate Director
Director		 Aug 24, 2023
Michael Saunders
Individual 		Corporate Officer
Assistant Secretary		 Feb 22, 2007
Paul C Rathbun
Individual 		Corporate Officer
Assistant Secretary		 Sep 11, 2014
David a Burt
Individual 		Corporate Director
Director		 Jan 1, 2009
Dennis a Hernandez
Individual 		Corporate Director
Director		 Apr 28, 2022
David a Weis
Individual 		Corporate Officer
President		 Aug 28, 2022
Francis Owens
Individual 		Contracted Managing Employee Feb 15, 2026
Corporate Officer
Cfo		 Feb 15, 2026
Operational/Managerial Control
Cfo		 Feb 15, 2026
Adventist Health System Sunbelt Healthcare Corporation
Organization · Altamonte Springs, FL
Corporation, Non-profit, Chain home office 		5% Or Greater Indirect Ownership Interest Oct 1, 2000 100%
Amanda Brady
Individual 		Corporate Officer
Assistant Secretary		 Feb 27, 2020
Toni Berrios
Individual 		Corporate Officer
Assistant Secretary		 Aug 25, 2022
Haney Vincent
Individual 		Corporate Officer
Assistant Secretary		 Dec 9, 2021
Nika Hosseini
Individual 		Corporate Director
Director		 Apr 4, 2024
James Arocho
Individual 		Corporate Director
Director		 Sep 11, 2014
Todd a Goodman
Individual 		Corporate Officer
Asst Secretary, Vice Chairperson		 Sep 14, 2017
Corporate Director
Director		 Feb 23, 2017
David R Sinclair
Individual 		Contracted Managing Employee
Ceo		 Mar 9, 2025
Corporate Officer
Ceo		 Mar 9, 2025
Operational/Managerial Control
Ceo		 Mar 9, 2025
David L Huffman
Individual 		Corporate Officer
Assistant Secretary		 Feb 27, 2020
Julie L Turpin
Individual 		Corporate Director
Director		 Aug 21, 2025
Robert C Foltz
Individual 		Corporate Officer
Assistant Secretary		 Sep 11, 2014
Lynn Addiscott
Individual 		Corporate Officer
Assistant Secretary		 Feb 5, 2002
Randall Haffner
Individual 		Corporate Director
Director		 Apr 8, 2021
Utpal Sureskumar Desai
Individual 		Corporate Director
Director		 Jan 1, 2025
John P Ferguson
Individual 		Corporate Director
Director		 Jun 8, 2017
Beverly Morgan
Individual 		Corporate Officer
Asst Secretary		 Aug 21, 2025
Adventist Health System Sunbelt Inc
Organization · Altamonte Springs, FL
Corporation, Non-profit, Owned by another organization or individual 		5% Or Greater Direct Ownership Interest Oct 1, 2000 100%

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040131000349 FL Part a Provider - Hospital 9739081142 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Daytona Beach, FL; Port Orange, FL; Palm Coast, FL; Ormond Beach, FL; New Smyrna Beach, FL

National Provider Directory

Tax ID family
Peter J Milazzo MD (8 organizations share this tax ID)
Part of
Peter J Milazzo MD

Locations (25 of 34)

103 Memorial Medical Pkwy
Ste 100
Daytona Beach, FL 32117
Phone (386) 231-3690

305 Memorial Medical Pkwy
Ste 203
Daytona Beach, FL 32117
Phone (386) 231-3512

305 Memorial Medical Pkwy
Ste 401
Daytona Beach, FL 32117
Phone (386) 231-3540

305 Memorial Medical Pkwy
Daytona Beach, FL 32117
Phone (386) 231-6039

305 Memorial Medical Pkwy
Ste 307
Daytona Beach, FL 32117
Phone (386) 231-3512

103 Memorial Medical Pkwy
Ste 225
Daytona Beach, FL 32117
Phone (386) 231-8820

1890 Lpga Blvd
Ste 170
Daytona Beach, FL 32117
Phone (386) 231-3284

305 Memorial Medical Pkwy
Ste 100
Daytona Beach, FL 32117
Phone (386) 231-6039

305 Memorial Medical Pkwy
Ste 208
Daytona Beach, FL 32117
Phone (386) 231-3570

125 Florida Memorial Pkwy
Ste 103
New Smyrna Beach, FL 32168
Phone (386) 409-6800

125 Florida Memorial Pkwy
Ste 2700
New Smyrna Beach, FL 32168
Phone (386) 409-6871

770 W Granada Blvd
Ste 204
Ormond Beach, FL 32174
Phone (386) 671-4500

325 Clyde Morris Blvd
Ste 320
Ormond Beach, FL 32174
Phone (386) 676-2367

873 Sterthaus Dr
Ste 206A
Ormond Beach, FL 32174
Phone (386) 673-8588

873 Sterthaus Dr
#206A
Ormond Beach, FL 32174
Phone (386) 673-8588

335 Clyde Morris Blvd
Ste 250
Ormond Beach, FL 32174
Phone (386) 231-4751

873 Sterthaus Dr
Ste 303
Ormond Beach, FL 32174
Phone (386) 671-6591

1425 Hand Ave
Ste F
Ormond Beach, FL 32174
Phone (386) 317-8500

873 Sterthaus Dr
#212
Ormond Beach, FL 32174
Phone (386) 676-6402

355 Clyde Morris Blvd
Ste 240
Ormond Beach, FL 32174

55 N Old Kings Rd
Ormond Beach, FL 32174
Phone (386) 677-4180

394 S Atlantic Ave
Ormond Beach, FL 32176
Phone (386) 672-6677

873 Sterthaus Dr
#303
Ormond Beach, FL 32174
Phone (386) 671-6591

873 Sterthaus Dr
#305
Ormond Beach, FL 32174
Phone (386) 671-6542

873 Sterthaus Dr
#301
Ormond Beach, FL 32174
Phone (386) 676-6172

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Yes

Addresses

Primary practice location

301 Memorial Medical Pkwy
Daytona Beach, FL 32117-5167

Mailing address

770 W Granada Blvd Ste 203
Ormond Beach, FL 32174-5179

Other names

  • AdventHealth Daytona Beach Doing business as

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL https://www.mettles.com/ Other

Other providers in Daytona Beach, FL

All providers in Daytona Beach, FL · Clinical Medical Laboratory in Florida

Sources for this page

Verify at the official NPI Registry.