Organization
DELTONA MEDICAL CENTER LLC
Active
Parent organization
MEDVANTX, INC.
Other names
Deltona Medical Center LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (VP OF OPERATIONS)
(858) 964-1506
Entity
Organization
Contact information
Practice address
747 FAWN RIDGE DR, SUITE 200, ORANGE CITY, FL 32763-8268
(386) 668-9800
Mailing address
5626 OBERLIN DR, SUITE 110, SAN DIEGO, CA 92121-1705
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
ME71092
FL
Other
Enumeration date
04/11/2014
Last updated
04/11/2014
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