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701 W Plymouth Ave Deland FL 32720-3236 | |
| (386) 943-4476 | |
| (386) 943-3685 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 701 W Plymouth Ave, Deland, Florida |
| Authorized Official Name and Position | Jonathan Armstrong (CFO) |
| Authorized Official Contact | 4074978195 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 864623 Orlando FL 32886-4623 Ph: (386) 671-4519 | 701 W Plymouth Ave Deland FL 32720-3236 Ph: (386) 943-4476 |
| NPI Number | 1669639415 |
|---|---|
| Provider Enumeration Date | 05/20/2008 |
| Last Update Date | 06/13/2024 |
| Medicare PECOS PAC ID | 5991763724 |
|---|---|
| Medicare Enrollment ID | O20041228000200 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669639415 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | April Dawn Morris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538129705 PECOS PAC ID: 5991604654 Enrollment ID: I20040102000223 |
| Provider Name | Marielle B Lazard |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1912040197 PECOS PAC ID: 4789670274 Enrollment ID: I20040421000841 |
| Provider Name | Tomas Rodriguez Molinet |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1003937244 PECOS PAC ID: 6002887155 Enrollment ID: I20040803001172 |
| Provider Name | Kauser Akhter |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1336111848 PECOS PAC ID: 6103877717 Enrollment ID: I20050201000524 |
| Provider Name | Albert J Razzetti |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770541062 PECOS PAC ID: 1456383637 Enrollment ID: I20050912000094 |
| Provider Name | Rosemarie A Latham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407925910 PECOS PAC ID: 1557381746 Enrollment ID: I20051202000284 |
| Provider Name | Mohammed Asif |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811928674 PECOS PAC ID: 4082629209 Enrollment ID: I20060209000233 |
| Provider Name | Lyle E Wadsworth |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356347561 PECOS PAC ID: 6709969140 Enrollment ID: I20080208000259 |
| Provider Name | Bharatkumar C Patel |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1922057249 PECOS PAC ID: 0547359853 Enrollment ID: I20080728000196 |
| Provider Name | Martin Gino F Prado |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1487603445 PECOS PAC ID: 7810086121 Enrollment ID: I20080728000261 |
| Provider Name | Aftab Qadir |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972674349 PECOS PAC ID: 6002803053 Enrollment ID: I20090219000469 |
| Provider Name | Chad L Broome-webster |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1669430732 PECOS PAC ID: 6204992886 Enrollment ID: I20090305000601 |
| Provider Name | Thomas M Corbyons |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1184658932 PECOS PAC ID: 8224939335 Enrollment ID: I20090727000570 |
| Provider Name | Ananth Krishnan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073521902 PECOS PAC ID: 7416003629 Enrollment ID: I20090914000055 |
| Provider Name | Hussain Rawji |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1932168721 PECOS PAC ID: 9830261536 Enrollment ID: I20091102000118 |
| Provider Name | Michael Joseph Donohoe |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1740215193 PECOS PAC ID: 6406757517 Enrollment ID: I20091215000075 |
| Provider Name | Christine A Aziz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437354958 PECOS PAC ID: 5890835185 Enrollment ID: I20091217000292 |
| Provider Name | Oscar D West |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1548220965 PECOS PAC ID: 3870628886 Enrollment ID: I20100316000776 |
| Provider Name | Reginald Schutt-aine |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083672380 PECOS PAC ID: 4789684283 Enrollment ID: I20100629000196 |
| Provider Name | Thomas Jude Montaldo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003864992 PECOS PAC ID: 0244230746 Enrollment ID: I20100713000518 |
| Provider Name | Mihir K Patel |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1649467218 PECOS PAC ID: 5890819692 Enrollment ID: I20100831000844 |
| Provider Name | Andrew J Randolph |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982775706 PECOS PAC ID: 1254510597 Enrollment ID: I20110119000755 |
| Provider Name | Candice Michele Ings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316263486 PECOS PAC ID: 7719160068 Enrollment ID: I20110323000535 |
| Provider Name | Samuel M Edwards |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386706000 PECOS PAC ID: 1951577253 Enrollment ID: I20120109000811 |
| Provider Name | Janak H Bhavsar |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1013995406 PECOS PAC ID: 2769410794 Enrollment ID: I20120803000454 |
| Provider Name | Maria Ana Jeanellee Soriano Co |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1376791798 PECOS PAC ID: 1557592037 Enrollment ID: I20140818000418 |
| Provider Name | Roy P Venzon |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1336333681 PECOS PAC ID: 4385715135 Enrollment ID: I20150622000090 |
| Provider Name | Mary Jane Venzon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821489204 PECOS PAC ID: 4789901992 Enrollment ID: I20151130001078 |
| Provider Name | Zachary Alexander Cavins |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1871989400 PECOS PAC ID: 1850648601 Enrollment ID: I20180725000363 |
| Provider Name | Sue-ellen Elizabeth Griffith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083066187 PECOS PAC ID: 9739474073 Enrollment ID: I20190610000680 |
| Provider Name | Robert Lee Solomon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073960357 PECOS PAC ID: 4486940582 Enrollment ID: I20190702002845 |
| Provider Name | Min Li Li Xu |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1083030977 PECOS PAC ID: 7810232089 Enrollment ID: I20190819000850 |
| Provider Name | Charles E Neetz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215489513 PECOS PAC ID: 9739460551 Enrollment ID: I20190905002771 |
| Provider Name | Christopher Lee Paik |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548748957 PECOS PAC ID: 5193149557 Enrollment ID: I20200720001124 |
| Provider Name | Shivani Pradip Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598362857 PECOS PAC ID: 8820400260 Enrollment ID: I20201209001336 |
| Provider Name | Michele Malit |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1528220225 PECOS PAC ID: 3476877721 Enrollment ID: I20211122001588 |
| Provider Name | Rachel Raphael |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1366641169 PECOS PAC ID: 4486897600 Enrollment ID: I20220211000443 |
| Provider Name | Erica Michelle Lapinsky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558016196 PECOS PAC ID: 0143615773 Enrollment ID: I20220317002810 |
| Provider Name | Rana Abusoufeh |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1477997492 PECOS PAC ID: 3779839451 Enrollment ID: I20220706000569 |
| Provider Name | Mays Raied Al-ani |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1023549995 PECOS PAC ID: 4880055904 Enrollment ID: I20230804001120 |
| Provider Name | Edwin Cheung |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1073010674 PECOS PAC ID: 9133573397 Enrollment ID: I20230922000066 |
| Provider Name | Michelle Lee Caro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548039423 PECOS PAC ID: 4183077696 Enrollment ID: I20240131005038 |
| Provider Name | Eric Omar Then |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1336677798 PECOS PAC ID: 3173999034 Enrollment ID: I20240625004025 |
| Provider Name | Frank Omar Velez |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1649579467 PECOS PAC ID: 7012259153 Enrollment ID: I20240701002127 |
Samuel M Edwards M D P A Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 750 W Plymouth Ave, Deland, FL 32720 Phone: 386-736-7244 Fax: 386-736-8538 | |
Mohan L Sharma Md Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 231 East Rich Ave, Deland, FL 32724 Phone: 386-736-1444 Fax: 386-736-9337 | |
Emmanuel Health Care Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 909 N Stone St, Deland, FL 32720 Phone: 386-279-7726 Fax: 386-873-2927 | |
Northeast Florida Health Services, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1205 S Woodland Blvd Ste 4, Deland, FL 32720 Phone: 386-202-6025 Fax: 386-202-1755 | |
Physicians Medical And Injury Group, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1450 S Woodland Blvd Ste 200a, Deland, FL 32720 Phone: 386-279-0943 Fax: 386-873-4217 |