DR. KAMAL WAHBA BOULOS (NPI# 1932369212) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932369212 |
| Entity Type | Individual |
| Full Name | DR. KAMAL WAHBA BOULOS |
| Credential | MD |
| Practice Address |
551 National Healthcare Dr Daytona Beach Va Outpatient Clinic Daytona Beach FL 32114-1495 |
| Mailing Address |
6810 Plumpjack Ct Port Orange FL 32128-4083 |
| Practice Telephone | 3863237500 |
| Practice Fax Number | 3863237503 |
| Mailing Telephone | 3862339774 |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2008-06-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | ME88745 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
551 NATIONAL HEALTHCARE DR DAYTONA BEACH VA OUTPATIENT CLINIC |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32114-1495 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376161380 | Evolution Health & Performance LLC | Physician Assistant | 244 S. Palmetto Ave, Daytona Beach, FL 32114 | 2020-07-07 |
| 1407480189 | Kierra Imani Kinsey | Behavior Technician | 1128-a Beville Rd, Daytona Beach, FL 32114 | 2020-03-02 |
| 1043776057 | Outreach Community Care Network Inc | Pharmacy | 240 N. Frederick Avenue, Daytona Beach, FL 32114 | 2019-02-14 |
| 1033681861 | Katherine Proppe | Specialist/Technologist | 1 Aerospace Blvd, Daytona Beach, FL 32114 | 2018-12-18 |
| 1841765047 | Anna L Smith | Nurse Practitioner | 339 Bill France Blvd Ste C, Daytona Beach, FL 32114 | 2018-10-04 |
| 1154806933 | Steve Anthony Lee | Family Medicine | 731 N. Clyde Morris Blvd, Daytona Beach, FL 32114 | 2018-09-27 |
| 1285116491 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1348 W International Speedway Blvd Ste 2, Daytona Beach, FL 32114 | 2018-09-04 |
| 1770085656 | Merina Lee | Occupational Therapist | 1159 Australia Ave., Daytona Beach, FL 32114 | 2018-03-06 |
| 1346752755 | Hand & Upper Extremity Surgery of Daytona Beach, LLC | Non-Pharmacy Dispensing Site | 1241 Ridgewood Ave, Daytona Beach, FL 32114 | 2017-10-26 |
| 1104347053 | Harry Herman Blanke IIi | Family Medicine | 201 N Clyde Morris Blvd, Suite 200, Halifax Health Family Medicine Residency Program, Daytona Beach, FL 32114 | 2017-06-30 |
| Find all providers in zip 32114 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| 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. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881947166 | Richard Wallace Snodgrass | Internal Medicine | 1151 N Halifax Ave, Daytona Beach, FL 32118-3654 | 2012-10-24 |
| 1235423070 | Tabitha Nicole Townsend | Internal Medicine | 303 N Clyde Morris Blvd Roc Bldg-2nd Floor, Halifax Health Center for Oncology, Daytona Beach, FL 32114-2709 | 2011-06-08 |
| 1841524691 | Willie P Potter | Internal Medicine | 647 Orange Ave., Daytona Beach, FL 32114 | 2009-09-28 |
| 1760649917 | Tinuade Olusegun | Internal Medicine | 140 S Beach St Ste 402, Daytona Beach, FL 32114-4409 | 2008-05-16 |
| 1508083866 | Anil Suryaprasad | Internal Medicine | 1435 Dunn Ave Ste 101, Daytona Beach, FL 32114-1434 | 2007-04-19 |
| 1235254863 | Dennis Doorneweerd | Internal Medicine | 1133 6th St, Daytona Beach, FL 32117-4142 | 2007-03-20 |
| 1316074701 | Mohammadreza Minouei | Internal Medicine | 303 N. Clyde Morris Blvd, Suite 201, Daytona Beach, FL 32114-2709 | 2007-02-27 |
| 1396837308 | Infectious Diseases of Mid-florida, Pa | Internal Medicine | 104 Lacosta Ln Ste 120, Daytona Beach, FL 32114-8160 | 2006-09-28 |
| 1083723605 | Robert Steven White | Internal Medicine | 601 N Clyde Morris Blvd, Daytona Beach, FL 32114-2321 | 2006-08-29 |
| 1265455349 | Marcil Essa Salem | Internal Medicine | 551 National Health Drive..dopc Vhc, 00, Daytona Beach, FL 32114 | 2006-07-26 |
| Find all providers in DAYTONA BEACH | ||||
| City | DAYTONA BEACH |
| Zip Code | 32114 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.