Provider Demographics
NPI:1063531804
Name:WILLS, DELINDA DEMITA (MD)
Entity type:Individual
Prefix:MS
First Name:DELINDA
Middle Name:DEMITA
Last Name:WILLS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:303 N CLYDE MORRIS BLVD
Mailing Address - Street 2:10E PBFS DEPT
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-2709
Mailing Address - Country:US
Mailing Address - Phone:386-226-4590
Mailing Address - Fax:386-226-3371
Practice Address - Street 1:303 N CLYDE MORRIS BLVD.
Practice Address - Street 2:HALIFAX HEALTH MEDICAL CENTER
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-2709
Practice Address - Country:US
Practice Address - Phone:386-254-4152
Practice Address - Fax:386-254-4315
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXS8505208600000X, 207RC0200X
LA15759R208600000X
MTMED-PHYS-LIC-1174062086S0102X
FL122738282NC0060X
AZ540292086S0102X
FLME1227382086S0102X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine