JERROLD ECKLIND DO PA
Ambulatory Health at Granada Blvd, Ormond Beach, FL

License number
Florida OS7663
Category
Ambulatory Health
Type
Medical Specialty
Owner
Name: DR. JERROLD RANDALL ECKLINDS D.O.
Title: PRESIDENT
Phone: (386) 615-8300
Address
Address
555 W Granada Blvd SUITE D-2, Ormond Beach, FL 32174
National Provider ID: 1548429590
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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Jerrold Ecklind, D.O., PA

555 W Granada Blvd, Ormond Beach, FL 32174

Status:
Inactive
Industry:
Family Doctor, Geriatrics
Doing business as:
Jerrold Ecklind DO
Registration:
Apr 17, 2001
Phone:
(386) 615-8300 (Phone)
State ID:
P01000038477
Business type:
Domestic for Profit Corporation
Vice Presidents:
Jerrold R. Ecklind President, Treasurer, Director, Secretary, inactive,Yolanda R. Ecklind Vice President, inactive
Agent:
Richard Churrhman

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