Organization
DELAND FAMILY MEDICINE PA
Active
Other names
DeLand Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MELANIE R VANDEMARK MD (OWNER)
(386) 740-1701
Entity
Organization
Contact information
Practice address
1450 S WOODLAND BLVD, SUITE 300C, DELAND, FL 32720-7767
(386) 740-1701
(386) 740-1798
Mailing address
PO BOX 741240, ORANGE CITY, FL 32774-1240
(386) 774-5211
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME912900
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52043
BCBS OF FL
FL
01
—
Q0182
MEDICARE PT AN
FL
Enumeration date
08/31/2006
Last updated
05/21/2008
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