Advanced Health Care Physical Medicine,LLC

Organization Active NPI General Practice Physician · Ormond Beach, FL

NPI 1063787331 · NPPES record last updated Mar 27, 2013

Key facts

NPI
1063787331
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Physician 208D00000X
License
ME60233 (FL)
Legal business name
ADVANCED HEALTH CARE PHYSICAL MEDICINE,LLC
Practice address
801 W Granada Blvd
Suite 101
Ormond Beach, FL 32174-8114
Phone
(386) 673-2000
Fax
(386) 673-2002
NPI assigned
Mar 20, 2012
Organization subpart
No

Authorized official

Name
Mrs. Hui Lin O'Connor
Title
Office Manager
Phone
(386) 673-2000

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

801 W Granada Blvd
#101
Ormond Beach, FL 32174
Phone (386) 673-2000

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician
Group: 193200000X MULTI-SPECIALTY GROUP
208D00000X ME60233 FL Yes

Addresses

Primary practice location

801 W Granada Blvd
Suite 101
Ormond Beach, FL 32174-8114

Mailing address

801 W Granada Blvd
Suite 101
Ormond Beach, FL 32174-8114
Phone (386) 673-2000

Other identifiers

IdentifierTypeStateIssuer
GH417AOtherFLMEDICAREPTAN

Other providers in Ormond Beach, FL

All providers in Ormond Beach, FL · General Practice Physician in Florida

Sources for this page

Verify at the official NPI Registry.