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Organization
EAST VOLUSIA FAMILY PRACTICE PA
Active
Organization
EAST VOLUSIA FAMILY PRACTICE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LANE E JENNINGS M.D. (PRESIDENT)
(386) 322-0811
Entity
Organization
Contact information
Practice address
3911 S NOVA RD, PORT ORANGE, FL 32127-4910
(386) 322-0811
(386) 761-5449
Mailing address
3911 S NOVA RD, PORT ORANGE, FL 32127-4910
(386) 322-0811
(386) 761-5449
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
02/13/2006
Last updated
07/09/2008
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