NPIMap

Organization Active NPI

Excellence Health Care at Home, LLC

  • Family Medicine Physician
  • Daytona Beach, FL
National Provider Identifier
1336906080
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
EXCELLENCE HEALTH CARE AT HOME, LLC
Practice address
1630 Mason Ave Ste C
Daytona Beach, FL 32117-4503
Phone
(386) 238-9064
NPI assigned
Feb 29, 2024
Last updated
Feb 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Authorized official

Name
Dr. Husam Eddin, MDNPI 1629082607
Title
Chief Executive Officer
Phone
(386) 238-9064

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

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

Mailing address

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

National Provider Directory

National Provider Directory

Locations

1630 Mason Ave
Ste C
Daytona Beach, FL 32117
Phone (386) 238-9064

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1709164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709164800000",
    "number": "1336906080",
    "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"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELLENCE HEALTH CARE AT HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-29",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A",
        "authorized_official_last_name": "EDDIN",
        "authorized_official_first_name": "HUSAM",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "386-238-9064",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.