Excellence Health Wound Care LLC

Primary specialty

Wound Care Registered NurseTaxonomy code 163WW0000X

Legal business name

EXCELLENCE HEALTH WOUND CARE LLC

Practice address

1630 Mason Ave Ste C
Daytona Beach, FL 32117-4503

Phone

(386) 238-9064

Fax

(386) 238-9063

NPI assigned

Jan 31, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Husam Eddin, MDNPI 1629082607

Title

Owner

Phone

(386) 238-9064

Specialties & licenses 1

Addresses

Other names 1

• Excellence Health Wound Care Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 6

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

• Husam Eddin, M.D

  • Family Medicine Physician
  • Daytona Beach, FL
  • NPI 1629082607
  Medicare reassignment NPD Authorized official
• Tiffany Varela Khan, APRN

  • Family Nurse Practitioner
  • Deltona, FL
  • NPI 1205451705
  Medicare reassignment NPD
• Kelli Knight Overturf, APRN

  • Primary Care Nurse Practitioner
  • Daytona Beach, FL
  • NPI 1902664568
  Medicare reassignment NPD
• Cindy Lynn Perdue, FNP-BC

  • Family Nurse Practitioner
  • Maitland, FL
  • NPI 1366103236

  Single Specialty

  Medicare reassignment NPD
• Delayna Siqueira, FNP

  • Family Nurse Practitioner
  • Ormond Beach, FL
  • NPI 1285390328
  Medicare reassignment NPD
• Kristin L Wulff, MD

  • Surgery Physician
  • Daytona Beach, FL
  • NPI 1285771444
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1675123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675123200000",
    "number": "1215633441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 MASON AVE STE C",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321174503",
            "telephone_number": "386-238-9064",
            "fax_number": "386-238-9063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 MASON AVE STE C",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321174503",
            "telephone_number": "386-238-9064",
            "fax_number": "386-238-9063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELLENCE HEALTH WOUND CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-31",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A",
        "authorized_official_last_name": "EDDIN",
        "authorized_official_first_name": "HUSAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-238-9064",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Wound Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Excellence Health Wound Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Excellence Health Specialist LLC
• Excellence Health, LLC
• Excellence Medical Labs LLC
• Exquisite Mobile Phlebotomy Corp
• Rachel Marie Jude Eyma, MD
• Michael A Fabian, M.D.

• Wound Care Registered Nurse in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Wound Care Registered Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.