# ADVANCED HEALTH CARE PHYSICAL MEDICINE,LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063787331
- **Authorized official:** MRS. HUI LIN O'CONNOR (OFFICE MANAGER)
- **Authorized official phone:** (386) 673-2000

## Contact information

- **Practice address:** 801 W GRANADA BLVD, SUITE 101, ORMOND BEACH, FL 32174-8114
- **Practice address phone:** (386) 673-2000
- **Practice address fax:** (386) 673-2002
- **Mailing address:** 801 W GRANADA BLVD, SUITE 101, ORMOND BEACH, FL 32174-8114
- **Mailing address phone:** (386) 673-2000
- **Mailing address fax:** (386) 673-2002

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | ME60233 | FL | Yes |

## Other

- **Enumeration date:** 03/20/2012
- **Last updated:** 03/27/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | GH417A | MEDICAREPTAN | FL |