Healthcare Provider Details

I. General information

NPI: 1669585337
Provider Name (Legal Business Name): TOWN CENTER FAMILY PRACTICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1642 N VOLUSIA AVE
ORANGE CITY FL
32763-3842
US

IV. Provider business mailing address

1642 N VOLUSIA AVE
ORANGE CITY FL
32763-3842
US

V. Phone/Fax

Practice location:
  • Phone: 386-774-0188
  • Fax: 386-774-1327
Mailing address:
  • Phone: 386-774-0188
  • Fax: 386-774-1327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NEETU SINGH
Title or Position: DIRECTOR / OWNER
Credential: MD
Phone: 386-774-0188