# AFERMIN PRIMARY CARE PA

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** FLETA MEDICAL CARE CENTER LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1740673300
- **Legal business name:** FLETA MEDICAL CARE CENTER LLC
- **Authorized official:** DR. PATRICK JOHN LARRAZABAL M.D. (OWNER/PROVIDER)
- **Authorized official phone:** (386) 334-1295

## Contact information

- **Practice address:** 2089 S RIDGEWOOD AVE, SOUTH DAYTONA, FL 32119-2240
- **Practice address phone:** (386) 767-7533
- **Mailing address:** 500 MEMORIAL CIR STE A, ORMOND BEACH, FL 32174-5054
- **Mailing address phone:** (386) 334-1295

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | ME0020477 | FL | Yes |
| 207R00000X | Internal Medicine Physician | ME0086562 | FL | — |

## Other

- **Enumeration date:** 03/06/2015
- **Last updated:** 03/28/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 069436300 | — | FL |
| 05 | — | 266766500 | — | FL |