Organization
MEMORIAL HEALTH SYSTEMS INC
Active
Other names
AdventHealth Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
CORY DOMAYER (VP)
(383) 231-3906
Entity
Organization
Contact information
Practice address
61 MEMORIAL MEDICAL PKWY STE 2811, PALM COAST, FL 32164-5999
(386) 671-4519
Mailing address
PO BOX 730729, ORMOND BEACH, FL 32173-0729
(386) 671-4500
(386) 672-9904
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
08/25/2006
Last updated
02/26/2021
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