Decesare, Gary Edward
Decesare, Gary Edward is an sole proprietor health care provider with primary practice located at 311 N Clyde Morris Blvd Ste 500 , Daytona Beach FL 32114-2768. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Plastic Surgery. Allopathic & Osteopathic Physicians / Plastic Surgery is his primary health care specialty. Decesare, Gary Edward can be contacted via phone (386) 238-2244.Contact Information
Primary practice address
311 N Clyde Morris Blvd Ste 500
Daytona Beach FL 32114-2768
Phone: (386) 238-2244
Fax: (386) 239-2381
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
Allopathic & Osteopathic Physicians / Plastic Surgery | 208200000X | ME123142 | Florida |
Profile Details
NPI number | 1093941635 |
---|---|
LBN Legal business name | Decesare, Gary Edward |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Jun 10th, 2009 |
Last updated | Aug 23rd, 2017 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1093941635 | NPPES |
Florida | MEDICAID | PENDING |
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