VOLUSIA MEDICAL CENTER LLC (NPI# 1073936415) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073936415 |
| Entity Type | Organization |
| Organization Name | VOLUSIA MEDICAL CENTER LLC |
| Other Organization Name | VOLUSIA MEDICAL CENTER DAYTONA |
| Practice Address |
575 N Clyde Morris Blvd Daytona Beach FL 32114-2323 |
| Mailing Address |
5626 Oberlin Dr Suite 110 San Diego CA 92121-1705 |
| Practice Telephone | 3864926680 |
| Enumeration Date | 2014-01-21 |
| Last Update Date | 2014-01-21 |
| Authorized Official Name | KENNY HEINE (VP OF OPERATIONS) |
| Authorized Official Telephone | 8589641506 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEDVANTX, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | ME98112 | FL | Suppliers |
| Other Name | Type Code |
|---|---|
| Volusia Medical Center Daytona | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902448715 | Volusia Medical Center LLC | Family Medicine | 850 N. Stone Street, Deland, FL 32720 | 2019-10-14 |
| 1710309398 | Volusia Medical Center LLC | Non-Pharmacy Dispensing Site | 161 N Causeway, Suite A, New Smyrna Beach, FL 32169-5303 | 2014-01-15 |
| 1629279138 | Volusia Medical Center LLC | Family Medicine | 3900 Clark Rd Ste L2, Sarasota, FL 34233 | 2007-05-31 |
| Street Address |
575 N CLYDE MORRIS BLVD |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32114-2323 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265409213 | Dva Healthcare Renal Care Inc | Clinic/Center | 575 N Clyde Morris Blvd, Ste A, Daytona Beach, FL 32114-2323 | 2006-03-08 |
| 1336575059 | Volusia Medical Center of Daytona, Pa | Clinic/Center | 575 N Clyde Morris Blvd, Daytona Beach, FL 32114-2323 | 2013-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376161380 | Evolution Health & Performance LLC | Physician Assistant | 244 S. Palmetto Ave, Daytona Beach, FL 32114 | 2020-07-07 |
| 1407480189 | Kierra Imani Kinsey | Behavior Technician | 1128-a Beville Rd, Daytona Beach, FL 32114 | 2020-03-02 |
| 1043776057 | Outreach Community Care Network Inc | Pharmacy | 240 N. Frederick Avenue, Daytona Beach, FL 32114 | 2019-02-14 |
| 1033681861 | Katherine Proppe | Specialist/Technologist | 1 Aerospace Blvd, Daytona Beach, FL 32114 | 2018-12-18 |
| 1841765047 | Anna L Smith | Nurse Practitioner | 339 Bill France Blvd Ste C, Daytona Beach, FL 32114 | 2018-10-04 |
| 1154806933 | Steve Anthony Lee | Family Medicine | 731 N. Clyde Morris Blvd, Daytona Beach, FL 32114 | 2018-09-27 |
| 1285116491 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1348 W International Speedway Blvd Ste 2, Daytona Beach, FL 32114 | 2018-09-04 |
| 1770085656 | Merina Lee | Occupational Therapist | 1159 Australia Ave., Daytona Beach, FL 32114 | 2018-03-06 |
| 1346752755 | Hand & Upper Extremity Surgery of Daytona Beach, LLC | Non-Pharmacy Dispensing Site | 1241 Ridgewood Ave, Daytona Beach, FL 32114 | 2017-10-26 |
| 1104347053 | Harry Herman Blanke IIi | Family Medicine | 201 N Clyde Morris Blvd, Suite 200, Halifax Health Family Medicine Residency Program, Daytona Beach, FL 32114 | 2017-06-30 |
| Find all providers in zip 32114 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346752755 | Hand & Upper Extremity Surgery of Daytona Beach, LLC | Non-Pharmacy Dispensing Site | 1241 Ridgewood Ave, Daytona Beach, FL 32114 | 2017-10-26 |
| 1659726248 | Advanced Urology Institute LLC | Non-Pharmacy Dispensing Site | 545 Health Blvd, Daytona Beach, FL 32114-1493 | 2016-05-02 |
| 1649601485 | Primecare Acquisition Inc | Non-Pharmacy Dispensing Site | 1890 Lpga Blvd, Suite 130, Daytona Beach, FL 32117-7130 | 2013-12-04 |
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| 1295358422 | Ezze Pharma LLC | Non-Pharmacy Dispensing Site | 3105 Nw 107th Ave Ste 400, Doral, FL 33172-2215 | 2020-05-21 |
| 1871115436 | Kempcare Inc. | Non-Pharmacy Dispensing Site | 840 Us Highway 1 Ste 435c, N Palm Beach, FL 33408-3829 | 2020-05-17 |
| 1427670595 | Orlando Dermatology Clinic, LLC | Non-Pharmacy Dispensing Site | 3261 Us Highway 441/27 Ste F1, Fruitland Park, FL 34731-4495 | 2020-05-12 |
| 1518593177 | Dedicated Senior Medical Center of Florida, LLC | Non-Pharmacy Dispensing Site | 2724 N Hiawassee Rd Ste 100, Orlando, FL 32818-3008 | 2020-03-16 |
| Find all providers with the same taxonomy | ||||
| City | DAYTONA BEACH |
| Zip Code | 32114 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.