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SHORES MEDICAL CENTER DAYTONA
NPI 1497166417
Non-Pharmacy Dispensing Site in Daytona Beach Shores, FL

Active since May 13, 2014
3512 S ATLANTIC AVE, DAYTONA BEACH SHORES, FL 32118(386) 767-9544 Get Directions Write a Review

NPPES record last updated: May 13, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Shores Medical Center Daytona NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHORES MEDICAL CENTER DAYTONA (NPI 1497166417) is a healthcare organization registered as a non-pharmacy dispensing site in Daytona Beach Shores, Florida and active in the NPI registry since May 2014. The organization lists Kenny Heine, Vp Of Operations, as its authorized official.

NPPES Registry Identity

NPI1497166417
Entity TypeOrganization
Primary Taxonomy332900000X
Legal Business NameGERALD R WOODARD DO PA
Location Address3512 S ATLANTIC AVEDaytona Beach Shores, FL 32118-7639
Mailing Address5626 Oberlin Dr, Suite 110San Diego, CA 92121-1705
Phone(386) 767-9544
Organization SubpartYesParent: Medvantx, Inc,
Authorized OfficialKenny HeineVp Of Operations · (858) 964-1506
Enumeration DateMay 13, 2014
✔ NPI 1497166417 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers
Taxonomy Code332900000X
License✔ Licensed in FL · OS4717
Definition
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
3512 S ATLANTIC AVE, Daytona Beach Shores, FL 32118
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Other Names 1

Doing Business AsShores Medical Center Daytona

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRUCE HARRIS ARNP
Nurse Practitioner (Family)
3512 S ATLANTIC AVE
DAYTONA BEACH, FL 32118
Volusia County (386) 767-9544
GERALD R WOODARD DO PA
Family Medicine
3512 S ATLANTIC AVE
DAYTONA BEACH SHORES, FL 32118
Volusia County (386) 767-9544
BETTINA FULFORD ARNP
Family Medicine
3512 S ATLANTIC AVE, SHORES MEDICAL CENTER
DAYTONA BEACH SHORES, FL 32118
Volusia County (386) 767-9544
DR. LAUREN A GIRARD DO
Family Medicine
3512 S ATLANTIC AVE
DAYTONA BEACH SHORES, FL 32118
Volusia County (386) 767-9544
EDWIDGE L RAOUL M.D.
Physical Medicine & Rehabilitation (Pain Medicine)
3512 S ATLANTIC AVE
DAYTONA BEACH SHORES, FL 32118
Volusia County (386) 767-9544
SMC REHAB SERVICES, LLC
Family Medicine (Geriatric Medicine)
3512 S ATLANTIC AVE
DAYTONA BEACH SHORES, FL 32118
Volusia County (386) 767-9544
TARA JAMES FNP
Nurse Practitioner (Family)
3512 S ATLANTIC AVE
DAYTONA BEACH SHORES, FL 32118
Volusia County (386) 767-9544
MRS. LESLEY SONDRA BOWLUS ARNP
Nurse Practitioner
3512 S ATLANTIC AVE
DAYTONA BEACH, FL 32118
Volusia County (386) 767-9544

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gerald R Woodard Do PA's NPI number?

The NPI number for Gerald R Woodard Do PA is 1497166417. It was assigned to this organization in the NPPES registry on May 13, 2014. The provider is doing business as Shores Medical Center Daytona.

Where is Gerald R Woodard Do PA located?

Gerald R Woodard Do PA is located at 3512 S Atlantic Ave, Daytona Beach Shores, FL 32118. The listed phone number is (386) 767-9544.

What is Gerald R Woodard Do PA's specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

When was this NPI record last updated?

The NPPES record for Gerald R Woodard Do PA was last updated on May 13, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.