Eddin Medical Services

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME94169 Issued in FL

Legal business name

EDDIN MEDICAL SERVICES

Practice address

2123 S Palmetto Ave
South Daytona, FL 32119-3005

Phone

(386) 341-3366

Fax

(386) 615-8208

NPI assigned

Apr 6, 2011

Organization subpart

No

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

Authorized official

Name

Husam Eddin, M.D.

Title

Owner

Phone

(386) 341-3366

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1302048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378857600000",
    "number": "1790074037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 291140",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321291140",
            "telephone_number": "386-341-3366",
            "fax_number": "386-615-8208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2123 S PALMETTO AVE",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321193005",
            "telephone_number": "386-341-3366",
            "fax_number": "386-615-8208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDDIN MEDICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-06",
        "last_updated": "2013-09-11",
        "status": "A",
        "authorized_official_last_name": "EDDIN",
        "authorized_official_first_name": "HUSAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-341-3366",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME94169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273953400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in South Daytona, FL
• Providers in South Daytona, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2013; 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.