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Organization

DAYTONA PLASTIC SURGERY, P.L.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. VIJAY J MORADIA M.B.,B.S. (MANAGING MEMBER)
(386) 756-9009
Entity
Organization

Contact information

Practice address
4606 S CLYDE MORRIS BLVD, SUITE 1 L, PORT ORANGE, FL 32129-6404
(386) 756-9009
(386) 756-3006
Mailing address
4606 S CLYDE MORRIS BLVD, SUITE 1 L, PORT ORANGE, FL 32129-6404
(386) 756-9009
(386) 756-3006

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
ME 62606
FL

Other

Enumeration date
01/09/2012
Last updated
01/09/2012
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