| Allergy Diagnostics Of Central Fl | |
|
211 S Volusia Ave Orange City FL 32763-5839 | |
| (386) 775-7500 | |
| (386) 775-1904 |
| Full Name | Allergy Diagnostics Of Central Fl |
|---|---|
| Speciality | Family Medicine |
| Location | 211 S Volusia Ave, Orange City, Florida |
| Authorized Official Name and Position | Mark E Webster (OWNER) |
| Authorized Official Contact | 3867757500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Allergy Diagnostics Of Central Fl 211 S Volusia Ave Orange City FL 32763-5839 Ph: (386) 775-7500 | Allergy Diagnostics Of Central Fl 211 S Volusia Ave Orange City FL 32763-5839 Ph: (386) 775-7500 |
| NPI Number | 1407054166 |
|---|---|
| Provider Enumeration Date | 07/04/2007 |
| Last Update Date | 11/23/2015 |
| Medicare PECOS PAC ID | 7416145933 |
|---|---|
| Medicare Enrollment ID | O20101228000933 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407054166 | NPI | - | NPPES |
| 059256100 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OS0003567 (Florida) | Primary |
| Provider Name | Marianne R Falasco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881730505 PECOS PAC ID: 5193791861 Enrollment ID: I20040909000985 |
| Provider Name | Susan R Hill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366440034 PECOS PAC ID: 8426242629 Enrollment ID: I20231112000046 |
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