Healthcare Provider Details

I. General information

NPI: 1376533018
Provider Name (Legal Business Name): DELAND CENTRAL PHYSICIANS ASSOC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 W PLYMOUTH AVE
DELAND FL
32720-3260
US

IV. Provider business mailing address

650 W PLYMOUTH AVE
DELAND FL
32720-3260
US

V. Phone/Fax

Practice location:
  • Phone: 386-736-6622
  • Fax: 386-736-6070
Mailing address:
  • Phone: 386-736-6622
  • Fax: 386-736-6070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. BETSY JOAN LEVIN
Title or Position: PRESIDENT
Credential:
Phone: 386-788-1881