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Organization
TRI COUNTY MEDICAL ASSOCIATES PA
Active
Organization
TRI COUNTY MEDICAL ASSOCIATES PA
Active
Other names
Deltona Fountains Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAMELA PEARSON HALL M.D. (VICE PRESIDENT)
(386) 860-4545
Entity
Organization
Contact information
Practice address
820 DELTONA BLVD, SUITE A, DELTONA, FL 32725-7177
(386) 860-4545
(386) 860-5632
Mailing address
820 DELTONA BLVD, SUITE A, DELTONA, FL 32725-7177
(386) 860-4545
(386) 860-5632
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
377330200
—
FL
01
—
CA7444
PALMETTO GBA GROUP NUMBER
—
Enumeration date
02/21/2007
Last updated
08/18/2008
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