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Contact Information

KATHLEEN FULKS
210 S BEACH ST STE 200
DAYTONA BEACH, FL32114-4433
 Phone: 386-898-6040
 Fax: 386-256-2320
 Website:
Indicates primary specialty

NPI Profile & details for

NPI Number 1952089187
Entity Organization
Organization subpart 1 Not specified
Enumeration date 07/07/2023
Last updated 09/19/2025 - About 9 months ago
Identifiers
FL License # RBT-23-28263
FL License # S17831
FL Medicaid 118810000
FL Other RBT-23-282263 RBT
FL Other S17831 SLPA
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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