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INTERNAL MEDICINE AT DEBARY LLC
NPI 1740088780
Internal Medicine in Debary, FL

Active since March 05, 2025CLIA 10D2331452 · Waiver
615 N CHARLES RICHARD BEALL BLVD, DEBARY, FL 32713(386) 210-9402 Get Directions Write a Review

NPPES record last updated: March 5, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Internal Medicine At Debary Llc NPPES

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

INTERNAL MEDICINE AT DEBARY LLC (NPI 1740088780) is a healthcare organization registered as an internal medicine in Debary, Florida and active in the NPI registry since March 2025. The organization holds a CLIA Waiver certificate valid through October 1, 2027 and lists Kwabena Ayesu, President, as its authorized official.

NPPES Registry Identity

NPI1740088780
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameINTERNAL MEDICINE AT DEBARY LLC
Location Address615 N CHARLES RICHARD BEALL BLVDDebary, FL 32713-2266
Mailing Address615 N Charles Richard Beall BlvdDebary, FL 32713-2266 · (386) 210-9402
Phone(386) 210-9402
Organization SubpartNo
Authorized OfficialKwabena AyesuPresident · (407) 493-3983
Enumeration DateMarch 5, 2025
NPPES CertifiedMarch 5, 2025
✔ NPI 1740088780 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
615 N CHARLES RICHARD BEALL BLVD, Debary, FL 32713
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2331452

Internal Medicine At Debary LLC · Debary, FL
Active · expires Oct 1, 2027
CLIA Number10D2331452
Laboratory TypePhysician Office
Certificate Effective DateOctober 2, 2025
Certificate Expiration DateOctober 1, 2027
Laboratory DirectorMalika George
Laboratory Phone(386) 210-9402
Laboratory LocationInternal Medicine At Debary LLC609 N Charles Richard Beall Blvd, Suite 105, Debary, FL 32713
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

MID FLORIDA URGENT CARE LLC
Clinic/Center (Urgent Care)
615 N CHARLES RICHARD BEALL BLVD
DEBARY, FL 32713
Volusia County (386) 837-5637

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 Internal Medicine At Debary LLC's NPI number?

The NPI number for Internal Medicine At Debary LLC is 1740088780. It was assigned to this organization in the NPPES registry on March 5, 2025.

Where is Internal Medicine At Debary LLC located?

Internal Medicine At Debary LLC is located at 615 N Charles Richard Beall Blvd, Debary, FL 32713. The listed phone number is (386) 210-9402.

What is Internal Medicine At Debary LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Internal Medicine At Debary LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2331452) is associated with this NPI, valid through October 1, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Internal Medicine At Debary LLC was last updated on March 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.