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General NPI Number Information
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NPI Number | 1265192926
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Entity Type | Organization
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Legal Business Name | ORMOND FAMILY MEDICAL CENTER PLLC
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Dates
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Enumeration Date | 12/22/2021
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Last Update Date | 10/01/2024
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Provider Practice Location Address
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Address Line | 545 W GRANADA BLVD
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City | ORMOND BEACH
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State | FL
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Zip | 32174-5103
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Country | US
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Telephone | 386-672-6243
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Fax | 386-677-7463
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Provider Business Mailing Address
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Address Line | 545 W GRANADA BLVD
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City | ORMOND BEACH
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State | FL
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Zip | 32174-5103
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Country | US
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Telephone | 386-672-6243
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Fax | 386-677-7463
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Authorized Official
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Title or Position | OWNER
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Name | STEPHANIE SANCHEZ
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Credential | APRN, FNP-BC
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Telephone | 407-415-3871
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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