Organization
ADVENTIST HEALTH SYSTEM/SUNBELT, INC.
Active
Parent organization
ADVENTIST HEALTH SYSTEM/SUNBELT, INC.
Other names
AdventHealth Centra Care - Port Orange
Organization subpart
Yes
Provider details
NPI number
Legal business name
ADVENTIST HEALTH SYSTEM/SUNBELT, INC.
Authorized official
SCOTT C. BRADY M.D. (PRESIDENT/CEO)
(407) 200-2300
Entity
Organization
Contact information
Practice address
1208 DUNLAWTON AVE, PORT ORANGE, FL 32127
(386) 304-7320
(386) 304-7374
Mailing address
2600 WESTHALL LANE, BOX 300, MAITLAND, FL 32751
(407) 200-2300
(407) 200-1352
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
261QU0200X
Urgent Care Clinic/Center
261QU0200X
—
261QU0200X
Urgent Care Clinic/Center
Primary
—
FL
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013961711
—
FL
01
—
B90NU
BCBS
FL
Enumeration date
05/13/2014
Last updated
04/20/2023
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