MEDICARE: DEBORAH L CONRAN D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	H00056241	MD
2	207Q00000X	Family Medicine Physician	C20008571	DE
3	207Q00000X	Family Medicine Physician	H0056241	MD
4	207Q00000X	Family Medicine Physician	OS20695	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699775056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH L CONRAN D.O.

Provider Business Mailing Address
First Line	:	1431 ORANGE CAMP RD STE 118
Second Line	:
City	:	DELAND
State	:	FL
Zip	:	32724-7770
Country	:	US
Telephone Number	:	386-943-3234
Fax Number	:	386-822-5487

Provider Business Practice Location Address
First Line	:	1431 ORANGE CAMP RD STE 118
Second Line	:
City	:	DELAND
State	:	FL
Zip	:	32724-7770
Country	:	US
Telephone Number	:	386-943-3234
Fax Number	:	386-822-5487

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	04/23/2024

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Directions to “ DEBORAH L CONRAN D.O.” Practice Location

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