Organization
FLORIDA DEPT. OF HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS COLEMAN MD (DIRECTOR)
(386) 274-0790
Entity
Organization
Contact information
Practice address
1061 MEDICAL CENTER DR, SUITE 100, ORANGE CITY, FL 32763-8200
(386) 274-0790
(386) 274-0800
Mailing address
PO BOX 9190, DAYTONA BEACH, FL 32120-9190
(386) 274-0790
(386) 274-0800
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
PH12890
FL
Other
Enumeration date
03/23/2007
Last updated
08/22/2020
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