Edc Of Volusia, Llc | |
780 Dunlawton Ave Suite 1 Port Orange FL 32127-4901 | |
(386) 322-6111 | |
(386) 322-3777 |
Full Name | Edc Of Volusia, Llc |
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Speciality | Internal Medicine |
Location | 780 Dunlawton Ave, Port Orange, Florida |
Authorized Official Name and Position | Christina Rho (OWNER) |
Authorized Official Contact | 3863226111 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Edc Of Volusia, Llc 1055 N Dixie Fwy Suite 1 New Smyrna Beach FL 32168-6201 Ph: (386) 423-0505 | Edc Of Volusia, Llc 780 Dunlawton Ave Suite 1 Port Orange FL 32127-4901 Ph: (386) 322-6111 |
NPI Number | 1285956037 |
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Provider Enumeration Date | 02/22/2010 |
Last Update Date | 11/18/2014 |
Medicare PECOS PAC ID | 4082759360 |
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Medicare Enrollment ID | O20100311000425 |
Identifier | Type | State | Issuer |
---|---|---|---|
1285956037 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | ME98466 (Florida) | Primary |
Provider Name | Christina Rho |
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Provider Type | Practitioner - Endocrinology |
Provider Identifiers | NPI Number: 1508063421 PECOS PAC ID: 1850473414 Enrollment ID: I20080205000103 |
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