# FLETA MEDICAL CARE CENTER, LLC

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

## Provider details

- **NPI number:** 1871991539
- **Authorized official:** MR. PATRICK JOHN LARRAZABAL MD (AR/ 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, SUITE A, ORMOND BEACH, FL 32174-5071
- **Mailing address phone:** (386) 334-1295

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/11/2014
- **Last updated:** 12/11/2014