Provider Demographics
NPI:1578633244
Name:COMMUNITY MEDICAL CENTER OF ORANGE CITY
Entity Type:Organization
Organization Name:COMMUNITY MEDICAL CENTER OF ORANGE CITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCELO
Authorized Official - Middle Name:R
Authorized Official - Last Name:ANAYAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:386-738-1792
Mailing Address - Street 1:810 COMMED BLVD
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-8322
Mailing Address - Country:US
Mailing Address - Phone:386-775-1792
Mailing Address - Fax:386-775-1750
Practice Address - Street 1:810 COMMED BLVD
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-8322
Practice Address - Country:US
Practice Address - Phone:386-775-1792
Practice Address - Fax:386-775-1750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health