Organization
GRANADA EMERGENCY PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY MEADOWS (VICE PRESIDENT)
(800) 507-8874
Entity
Organization
Contact information
Practice address
875 STERTHAUS AVE, ORMOND BEACH, FL 32174-5131
(386) 676-6022
(386) 676-6255
Mailing address
PO BOX 41752, PHILADELPHIA, PA 19101-1752
(800) 507-8874
(727) 507-3630
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
269147700
—
FL
Enumeration date
05/09/2006
Last updated
05/13/2008
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