| West Volusia Psychiatric Associates | |
|
250 Treemont Dr Orange City FL 32763-7945 | |
| (386) 774-6001 | |
| (386) 774-6044 |
| Full Name | West Volusia Psychiatric Associates |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 250 Treemont Dr, Orange City, Florida |
| Authorized Official Name and Position | Edmundo I Rivera (MEDICAL DOCTOR) |
| Authorized Official Contact | 3867746001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| West Volusia Psychiatric Associates 250 Treemont Dr Orange City FL 32763-7945 Ph: (386) 774-6001 | West Volusia Psychiatric Associates 250 Treemont Dr Orange City FL 32763-7945 Ph: (386) 774-6001 |
| NPI Number | 1477839306 |
|---|---|
| Provider Enumeration Date | 10/24/2011 |
| Last Update Date | 10/24/2011 |
| Medicare PECOS PAC ID | 9436319316 |
|---|---|
| Medicare Enrollment ID | O20120330000206 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477839306 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | ME62400 (Florida) | Primary |
| Provider Name | Edmundo I. Rivera |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437231115 PECOS PAC ID: 3971763855 Enrollment ID: I20120330000242 |
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