# ALLERGY DIAGNOSTICS OF CENTRAL FL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** WEBSTER MEDICAL CLINIC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407054166
- **Authorized official:** DR. MARK E WEBSTER D.O. (OWNER)
- **Authorized official phone:** (386) 775-7500

## Contact information

- **Practice address:** 211 S VOLUSIA AVE, ORANGE CITY, FL 32763-5839
- **Practice address phone:** (386) 775-7500
- **Practice address fax:** (386) 775-1904
- **Mailing address:** 211 S VOLUSIA AVE, ORANGE CITY, FL 32763-5839
- **Mailing address phone:** (386) 775-7500
- **Mailing address fax:** (386) 775-1904

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | OS0003567 | FL | Yes |

## Other

- **Enumeration date:** 07/04/2007
- **Last updated:** 11/23/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 059256100 | — | FL |