King, Loretha

King, Loretha is an individual health care provider with primary practice located at 143 Executive Cir , Daytona Beach FL 32114-1180. She recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as her primary health care specialty. King, Loretha can be contacted via phone (772) 233-9515.

Contact Information

Primary practice address
143 Executive Cir Daytona Beach FL 32114-1180
Phone: (772) 233-9515
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X OS8310 Florida

Profile Details

NPI number 1578699351
LBN Legal business name King, Loretha
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 26th, 2007
Last updated Oct 13th, 2020 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578699351 NPPES
Florida MEDICAID 279101300

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