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Organization
MEMORIAL HEALTH SYSTEMS INC
Active
Organization
MEMORIAL HEALTH SYSTEMS INC
Active
Other names
AdventHealth Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
CORY DOMAYER (VP)
(383) 231-3906
Entity
Organization
Contact information
Practice address
61 MEMORIAL MEDICAL PKWY STE 2811, PALM COAST, FL 32164-5999
(386) 671-4519
Mailing address
PO BOX 730729, ORMOND BEACH, FL 32173-0729
(386) 671-4500
(386) 672-9904
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
08/25/2006
Last updated
02/26/2021
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