Registry details
Type
Organization
Primary specialty
Family Medicine
Enumerated
Feb 1, 2017
License(s)
ME074829 (FL), ME92729 (FL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 2111 HONTOON RD | Deland, FL 32720-4308 | 386-747-9771 |
| LOCATION | 2728 ENTERPRISE RD STE 200 | Orange City, FL 32763-8276 | 386-747-9771 |
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