JERROLD ECKLIND DO PA NPI 1548429590

NPI Information

  • NPI: 1548429590
  • Provider Name: JERROLD ECKLIND DO PA
  • Classification: Clinic/Center - 261QM2500X
  • Specialization: Medical Specialty
  • Entity Type: Organization
  • Address: 555 W GRANADA BLVD
    SUITE D-2
    ORMOND BEACH, FL
    ZIP 32174
  • Phone: (386) 615-8300

Map and Directions

Get Directions

NPI Details

JERROLD ECKLIND DO PA is a medical specialty clinic center in Ormond Beach, FL. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). JERROLD ECKLIND DO PA NPI is 1548429590. The provider is registered as an organization entity type.

The provider's business location address is:

555 W GRANADA BLVD
SUITE D-2
ORMOND BEACH, FL
ZIP 32174-485
Phone: (386) 615-8300
Fax: (386) 677-1818

The provider's authorized official is Jerrold Randall Ecklinds .
The authorized official title is President and has the following contact phone number (386) 615-8300.

The enumeration date for this NPI number is 6/5/2008 and was last updated on 6/27/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM2500XClinic/CenterMedical SpecialtyOS7663FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11851390322OTHERFLORIDANPI
2G79491MEDICARE UPINFLORIDA
349221OTHERFLORIDABLUE CROSS BLUE SHIELD
4E1206MEDICARE PINFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI